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말초감각신경 자극이 동맥혈압변화에 미치는 영향에 관한 연구
임승평,김전,김종환,Lim, Seung-Pyung,Kim, Jun,Kim, Chong-Whan 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.3
The arterial blood pressure response elicited by stimulating the peripheral afferent fibers of different groups and origins was studied in cats. Experimental animals were anesthetized with a-chloralose [60mg/kg] and artificially ventilated with a respirator. The lumbosacral spinal cord was exposed through a laminectomy and L7 ventral root was isolated. The sural, medial gastrocnemius and common peroneal nerves were also exposed in the hindlimb. The arterial blood pressure was monitored continuously while the exposed peripheral nerves and L7 ventral root were being stimulated. Then, spinal lesions were made on the dorsolateral sulcus area, dorsolateral funiculus and other areas at the thoracolumbar junction. The arterial blood pressure responses were compared before and after making spinal lesions. The following results were obtained. 1. The mean arterial blood pressure was elevated from 103*7.3 to 129*8, 1 [mean*S.E.] mmHg [p<0.001] during stimulation of the sural nerve with C-strength [1000T], 20Hz. Stimulation with Ad-strength, 1Hz resulted in the depression of the arterial pressure by 8 mmHg [p<0.01]. 2. Stimulation of the medial gastrocnemius nerve with Ad-strength did not elicit any significant change in arterial blood pressure. Stimulation with C-strength, 20 Hz induced a pressor response from 102*6.2 to 117*6.4 mmHg [p<0.01] while that with C-strength, 1Hz induced a depressor response from 104*6.1 to 93*4.9 mmHg [p<0.001]. 3. A pressor response by 56 [from 107*7 5 to 163*9.4] mmHg [p<0.001] was induced during stimulation of the common peroneal nerve with C-strength, 20Hz stimuli. Stimulation with A4-strength, 1Hz depressed the arterial blood pressure from 111~9.3 to 94*7.8 mmHg [P<0.005]. The activation of the ventral root afferent fibers with C-strength, 20 Hz stimuli induced a pressor response by 22 mmHg [from 115*9.4 to 137*8.6 mmHg] [p<0.001]. 4. The pressor response elicited during stimulation of the sural nerve was abolished by making lesions on the dorsolateral sulcus area bilaterally. With the medial gastrocnemius nerve, the pressor response had not been abolished completely by the dorsolateral sulcus lesions. The pressor response disappeared completely with addition of the bilateral dorsolateral funiculus lesions. 5. The depressor response induced by stimulation of the sciatic nerve with Ad-strength, 1Hz was decreased by making lesions on the dorsolateral funiculus. 6. From the above results it is concluded that the difference in the blood pressure responses to the activation of the muscular afferent and the cutaneous afferent fibers is responsible for the groups of afferent fibers and the spinal ascending pathways.
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.
박경신,임승평,이영,Park, Kyung-Sin,Lim, Seung-Pyung,Lee, Young 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.6
Recently, primary lung cancer has increased markedly in incidence and prevalence in Korea. From January 1986 to June 1993, 86 patients were operated and evaluated at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The results are as follows; 1. There were 79 males and 7 females with the peak incidence of 5th and 6th decades of life[75.6% . The age ranged from 13 to 76[mean 56.6$\pm$10.3 years. 2. Symptoms were cough[47.7% , sputum[25.6% , chest pain or dyspnea[18.6% , and hemoptysis or blood tinged sputum[20.9% in order. Symptoms were frequently encountered before hospitalization, but asymtomatic patients were 12.8% in this study. 3. Methods of diagnostic confirmatiom were bronchoscopic biopsy[55.8% , percutaneous needle aspiration[29.1% , suspicious sputum cytology[1.2% , and open biopsy[14.0% . 4. Histopathologically, squamous cell carcinoma[51.2% was the most frequent cell type and adenocarcinoma[26.7% , large cell carcinoma[8.1% , adenosquamous cell carcinoma[3.5% , and the others in order. And TNM stages were Stage I 40.5%, Stage II 15.5%, Stage IIIa 27.4%, and Stage IIIb 3.6%. 5. Methods of operation were pneumonectomy[25.6% , bilobectomy[5.8% , lobectomy[53.4% , segmentectomy[1.2% , and exploration[14.0% . The overall resectability was 86.0% 6. The operative mortality was 2.3% and postoperative complications developed in 7 cases[8.1% . 7. The postoperative follow-up reveals that the overall cumulative survival rates at 1 year, 2 year, 3 year, 4 year, 5 year were 76%, 62%, 43%, 36%, and 27%, respectively.
박경신,임승평,이영,Park, Kyung-Sin,Lim, Seung-Pyung,Lee, Young 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.4
Pulmonary actinomycosis is a chronic pulmonary infection characterized by suppuration, abscess formation, and dense scarring. The causative agent, Actinomyces israelii, is a gram-positive, microaerophilic bacterium that resemble fungi. We recently treated two cases of pulmonary actinomycosis. A patient was underwent right lower lobectomy under the impression of bronchiectasis. Pulmonary actinomycosis was diagnosed of postoperatively. He was medicated with high-dose penicillin parenterally. The other patient was also undergone right lower lobectomy under the impression of broncholithiasis and received parenteral penicillin and oral roxythromycin. There was no recurrence or development of empyema. The purpose of this paper is to review of our experience and to enhance consideration of pulmonary actinomycosis.
안혁,장병철,임승평,Ahn, Hyuk,Chang, Byung-Chul,Lim, Seung-Pyung 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.1
A 25 years old male patient with traumatic aneurysm of descending thoracic aorta was treated successfully. He was admitted due to blunt trauma to the chest wall as falling down into water. He has been treated with closed thoracotomy and close observation. After a month simple chest film showed abnormal mass shadow around the aortic knob. Aortogram revealed aneurysm of descending thoracic aorta. Aneurysm was resected and replaced with woven Dacron graft with aid of Gotts shunt. His postoperative course was uneventful.
외과적 치료가 필요했던 심도자 합병증에 대한 임상적 고찰
이영,박경신,박진석,임승평,김응중,Lee, Young,Park, Kyung-Sin,Park, Jin-Seog,Lim. Seung-Pyung,Kim, Eung-Joong 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.6
We have experienced ten cases of emergent operation for the complications of cardiac catheterization during the period from 1985 to September 1994.Catheterization was done for the evaluation of the cardiac or vascular problem in 8 cases and 2 cases of neurosurgical problem. The extracardiac injection of contrast material have occurred in 3 cases[primum ASD,Trilogy,VSD . Six cases were unable to remove the catheter from femoral artery or vein. The catheters were knotted, coiled, impacted or broken. An embolectomy was done 40 years old man who suffered from chronic left subclavian artery obstruction a day after angiography. Open heart surgery was performed in 5 cases of cardiac perforation,impacted catheter in left inferior pulmonary vein and broken catheter of VSD. Arteriotomy was done in 4 cases to remove the knotted and coiled catheter. There was no complication or mortality for the emergent operation.
윤수영,박상순,나명훈,유재현,임승평,이영,Yoon, Soo-Young,Park, Sang-Soon,Na, Myung-Hoon,Yu, Jae-Hyeon,Lim, Seung-Pyung,Lee, Young 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.12
26세 남자가 길가다 버스에 치어, 다발성 늑골골절, 흉골골절, 우견갑골골절, 좌쇄골하동맥 폐색, 외상성 기관식도루로 입원 치료 중 이완기 심잡읍이 생겼다. 심초음파 검사에서 심한 대동맥판 폐쇄 부전과 증식물로 진단하였다. 심폐기 운영 하에 좌 우 관상 동맥 첨판에 10mm, 7mm 파열을 발견 5-0 Prolene 연속 봉합하여 좋은 수술 결과를 얻고 환자는 수술 14일에 퇴원하였다.
좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 -
강신광,박상순,나명훈,유재현,임승평,이영,성인환,Kang, Shin-Kwang,Park, Sang-Soon,Na, Myung-Hoon,Yu, Jae-Hyeon,Lim, Seung-Pyung,Lee, Young,Seong, In-Whan 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.6
17세 여자 고등학교 학생이 전흉부 동통을 주소로 입원하였다. 약물 치료와 대동맥내 풍선 펌프에도 불구하고 폐부종과 순환 허탈이 악화되었다. 급성 전격성 심근염 추정 진단 하에 좌심실 보조장치를 설치하였다. 유입구 도관은 유방하 좌전개흉술로 좌심이를 통하여 좌심방에 삽입하였고, 좌심이의 일부를 조직검사를 위해 떼어냈다. 유출구 도관은 좌측 대퇴 동맥에 PTFE도관을 간치시켜 삽입하였다. 체외순환 158시간 후 심초음파에서 좌심실의 운동성이 거의 정상으로 회복되었고, 좌심실 보조장치를 성공적으로 이탈할 수 있었다. 면역화학 검사와 중화 항체 검사에서 콕사키바이러스가 확인되었다. 환자는 입원 23일 째 아무런 심부전 증상없이 퇴원하였다. A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.
강신광,김시욱,원태희,구관우,박상순,유재현,나명훈,임승평,이영,Kang, Shin-Kwang,Kim, Si-wook,Won, Tae-Hee,Ku, Kwan-Woo,Park, Sang-Soon,Yu, Jae-Hyun,Na, Myung-Hoon,Lim, Seung-Pyung,Lee, Young 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.12
폐동정맥루는 비교적 흔하지 않은 질환이다. 뇌농양은 폐동정맥루의 드물고, 가장 심각한 합병증이며, 폐동정맥루는 신경학적 증상으로 처음 발현되는 수도 있다. 저자들은 뇌농양으로 발견된 폐동정맥루를 치험하였기에 보고하는 바이다. Pulmonary arteriovenous malformations(PAVM) are uncommon diseases. Brain abscesse could be a rare and devastating comlplication of PAVM. Central nervous complaints may be the first manifestations of PAVM. We report a case of PAVM presented by brain abscess which was treated by craniotomy.