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고영관,이희수,주홍재 대한응급의학회 1991 대한응급의학회지 Vol.2 No.1
This report consists of the review of 69 patients who were admitted to the department of surgery, Kyung Hee University Hospital with blunt abdominal trauma sustained from motor-vehicle accident during the period from January, 1986 to December,1990. The results were as follows : 1) The sex distribution was 44 males and 25 females with significant predominance in male(1.76:1) and the age distribution revealed a high incidence in first decade, followed by fourth(18%) and third decade(17.3%). 2) The seasonal distribution showed the lower incidence in winter(17.4%). 3) Out of the 69 cases of trauma, 31 cases(44%) were automobile accident and 38 cases(56%) were auto-pedestrian accident. 4) The clinical manifestations were abdominal pain(82.6%), abdominal tenderness(66.6%), decreased bowel sound(36.2%), abdominal distension(24.6%), rebound tenderness(23.1%), and abdominal rigidity(17.3%) 5) Nineteen out of twenty five-operation-cases were counted as 10,000-20,000/㎣ W.B.C. 6) The number of subdiaphragmatic free air shadow on upright chest view was 4 cases(40%) out of 10 cases of hollow viscus perforations. 7) The abdominal paracentesis was positive in 13 cases(86.6%) out of 15 cases. 8) The injured organs were small bowel(25.4%), spleen(23.1%), liver(20.5%), mesentery(12.8%), and colon(5.1%) in order of decreasing frequency. 9) The associated extraabdominal injuries were head trauma(29.0%), chest trauma(27.9%), 11) Seventeen cases(68.0%) were operated within 6 hours from arrival at emergency room. 12) The most common complication was wound infection(31.0%), followed by pulmonary complication(22.0%) and intraabdominal abscess(13.6%). 13) The causes of death were hypovolemic shock(2 cases), brain trauma(1 case), and sepsis(1 case). 14) The overall mortality was 5%.
이근,고영관,주홍재,성충경,양혁준,김명천 대한외상학회 1998 大韓外傷學會誌 Vol.11 No.1
In the management of multiple trauma, especially combined with head injury and abdominal injury, the initial diagnosis and treatment are determined with difficulty. We studied 50 trauma patients who were combined with head injury and abdominal injury to assess the correlation with the status of patients, diagnosis, treatment and prognosis. Glasgow Coma Scale on admission and lateralizing sign as the predictor for surgical intervention of intracranial injury are statistically important, and other factors such as motor vehicle accident, field intubation, age more than 60 years, sex, anisocoria, fixed or dilated pupil, abdominal surgery and facial or scalp injury are statistically unimportant. Only 3 patients required both craniotomy and celiotomy. Even in the patient with positive paracentesis, head CT should be checked if neurologic findings are abnormal. Paracentesis and peritoneal lavage have been proper methods for detection of an abdominal injury. At present, abdominal ultrasonography can be substituted with peritoneal lavage and spiral computed tomography is possible to evaluate head and abdomen simultaneously without delay of diagnosis and treatment for those two organ injuries. On the base of objective data in addition to physical examination, the management of trauma patient must be done.
저분자량 Heparin이 배양 혈관 평활근세초의 증식에 미치는 영향
이태석,박호철,주홍재,문익언 대한혈관외과학회 1995 Vascular Specialist International Vol.11 No.1
Intimal hyperplasia is one of the most important cause of vascular graft failure within the first year after operation. This process of structural change with progressive luminal obliteration is caused by thickening of the vessel wall between the internal elastic lamina and the endothelium appears to be a response to injury. The cellular processes resulting in intimal hyperplasia involve the migration and proliferation of smooth muscle cells from the vessel media. Heparin possesses antiproliferative effects capable of inhibiting intimal hyperplasia following arterial injury, but conventional heparin needs to be administered continuously and that is associated with side-effects. The recent development of low molecular weight heparin (LMWH) has provided an effective and acceptable method of treating patients by once-daily subcutaneous injection. To investigate the potential uses of LMWH as prophylactic agents against intimal hyperplasia in arterial bypass surgery, the vascualr smooth muscle cells were harvested from normal artery and plaque-formed artery and cultured. During the culture, 0, 1.0, 10.0 and 100.0 μg/ml LMWH were added to each media, and calculated the population doublings and the population doubling time. The results were as follows; 1) The size of cultured smooth muscle cell(SMC) of plaque-formed artery was larger than that of SMC of normal artery. 2) In SMC of normal artery, the population doubling time is delayed according to subculture. 3) On electron microscopic finding, cultured SMC showed long and slender, and had many pseudopodia on surface of the cells. 4) In culture of SMC from normal artery, LMWH inhibited the proliferation of SMC from 6th day of cultivation effectively(p$lt;0.05). Over 10 μg/ml of LMWH, the effect of suppression is increased signigicantly according to their concentration(p$lt;0.05). 5) In culture of SMC from plaque-formed artery, LMWH inhibited the proliferation of SMC from 3rd day(p$lt;0.05), but the effect was not increased significantly according to concentration.