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내피세포성 이완인자에 대한 세포외 $Ca^{2+}$및$Ca^{2+}$-길항제의 작용기전
진성훈 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.3
A bioassay technique and organ bath study were performed to analyze the effects of extracellular $Ca^{2+}$ and $Ca^{2+}$-antagonists on endothelium-derived relaxing factor[s][EDRF] released from the endothelial cells of rabbit aorta. Transverse strips with intact endothelium or damaged endothelium were used for the mechanical contraction experiment using organ bath. Long segment including thoracic and abdominal aorta with endothelium [EDRF donor aorta] was perfused with Tyrode solution which was aerated with 95% $O_2-5%$ $CO_2$ mixed gas and kept at 35oC. The perfusate was bioassayed with a transverse strip of thoracic aorta with damaged endothelium. The test strip was contracted with nor-epinephrine and acetylcholine was used to stimulate the release of EDRF from endothelial cells. The results obtained were as follows; 1] The endothelium-dependent relaxation[EDR] induced by acetylcholine was biphasic; an initial rapid relaxation followed by a slow relaxation. 2] EDR induced by acetylcholine was reduced gradually with the decrease in the concentration of extracellular $Ca^{2+}$. The effect of extracellular $Ca^{2+}$ on EDR was more prominent in the late slow relaxation phase. 3] EDR to acetylcholine was not altered by acute exposure to organic $Ca^{2+}$-antagonists. Pretreatment with verapamil to the EDRF donor aortic segment did not alter the magnitude of EDR. 4] Among the inorganic $Ca^{2+}$-antagonists $Mn^{2+}$ and $Cd^{2+}$ did not inhibit EDR, whereas $Co^{2+}$ and $La^{3+}$ inhibited EDR. 5] The inhibitory response of $Co^{2+}$ to EDR developed when infused directly on the test strip. That of $La^{3+}$, however, was evoked when added to solution perfusing the donor aortic segment. The above results suggest that $Ca^{2+}$-antagonists do not affect EDR and the inhibitory effect of $Ca^{2+}$ results from influencing the action of EDRF on vascular smooth muscle, whereas that of $La^{3+}$ results from its action on the release of EDRF from endothelial cells.
진성훈 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.2
One hundred thirteen cases of open heart surgery were performed in the department of thoracic and cardiovascular surgery of Inha General Hospital from April 1986 to April 1987. There were 73 cases of congenital heart disease and 40 cases of acquired valvular heart disease, including one redo case respectively. The technique of deep hypothermia with circulatory arrest was used widespreadly for infants and small children, and early extubation was performed as possible in the great number of all cases. There were three operative deaths [2.7%], all in congenital cases, and three follow-up deaths, all in acquired cases.
도플러 초음파를 이용한 인공판막 상하의 압력차 측정에 관한 연구 -승모판막 치환에 사용한 Duromedics 인공판막과 정사인의 승모판막과의 비교연구-
진성훈,서경필,Jin, Seong-Hun,Seo, Gyeong-Pil 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.2
Doppler echocardiography provides valuable information regarding prosthetic heart valve function rather than structure. There are three methods of expressing the severity of mitral valve obstruction: the transvalvular pressure gradient, effective valve area, and pressure half-time. Of these, the transvalvular pressure gradient [~p] can be determined by the measurement of maximum transvalvular blood flow velocity [V] according to the modified Bernoulli`s equation [gp=4V*]. Eleven patients, who underwent mitral valve replacement with Duromedics mechanical prostheses, and 17 normal persons were investigated. There were significantly higher calculated pressure gradients in prosthetic than normal mitral valves [9.*10*2.22mmHg-vs-3.26*0.99mmHg:p<0,01], and there was a inverse relationship between pressure gradient and prosthetic valve size [11.17*0.%mmHg in size 27mm and 29mm -v- 7.38*1.12mmHg in size 31mm and 33mm; r=0.85, p<0.01] The noninvasive Doppler technique should be useful in the diagnosis of prosthetic valve obstruction.
체중 10 kg 이하의 선천성 심장병환자에 대한 교정수술
진성훈,서경필,Jin, Seong-Hun,Seo, Gyeong-Pil 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.1
Between January 1980 and July 1984, 321 cases of open heart surgery for infants or small children under 10Kg of body weight were performed, which occupied the great part of total open heart surgery done in the same period. The mean age was 16.58.7 months [ranging from 2 days to 51 months], and the mean body weight was 7.8a1.8Kg [from 2.8 to 10Kg] which was below the third percentile compared with the mean age. The technique of deep hypothermia with total circulatory arrest, which contributed to great improvement in operative condition, was used increasingly and widespreadly in this period. For each anomaly, the number of patients and operative deaths were as follows: VSD, 11 of 184 [6.0%]; TOF, 8 of 47 [17.8%]; TGA, 13 of 30 [43.3%]; ASD, none of 9; TAPVR, 1 of 8 [12.7%]; C-ECD, 3 of 6 [50%]; Tricuspid Atresia, 4 of 5 [80%]; Pulmonary Atresia, 2 of 4 [50%]; Congenital Mitral Anomaly, 1 of 3 [33.3%]; P-ECD, none of 3
진성훈,김주현,Jin, Seong-Hun,Kim, Ju-Hyeon 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.2
Congenital Cystic Adenomatoid Malformation [C.C.A.M], one of lung bud anomalies, is an unusual lesion, only about 200 cases baring been reported by 1980, and characterized by marked proliferation of terminal respiratory structures. Recently we experienced two infants with C.C.A,M., whose clinical courses were quite different. On case 1, the patient was 25-day-old female, and suffered from progressive respiratory distress for 10 days duration. A right middle lobectomy was performed, with a satisfactory postoperative course. On case II, the patient was 7omonth-old male, and admitted for evaluation of known pulmonary anomaly, which was detected for the first time during hospitalization for treatment of pneumonia at 1 month of his age. He underwent a lingular segmentectomy, but died of respiratory insufficiency on postop 10th day. We believe that awareness of the presence of C.C.A.M. is important in making the differential diagnosis of progressive respiratory disease or of recurrent pulmonary infection in infants.
선천성 청색증 심장병에 대한 고식적 수술: 102례 보
진성훈 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.1
From Jan. 1962 to Aug. 1983, one hundred patients with cyanotic heart disease underwent various palliative operations at the department of thoracic and cardiovascular surgery, S.N.U.H. In the period from Jan. 1962 to Dec. 1973, in which the open heart surgery was not routinely performed, sixty-two operations including 2 cases of second shunt operation were performed in sixty patients, and all of them were tetralogy of Fallot except three cases. Various palliative procedures such as Glenn, Brock, Waterston and Blalock-Taussing operation were used in this period with overall mortality rate of 16%. In the period from Jan. 1980 to Aug. 1983, forty patients with cyanotic heart disease were operated and majority of them was complex anomalies. Only Blalock-Taussing operation was used in this period with a mortality rate of 20%. These two groups of patients were compared according to age, diagnosis and results of operations, and it appears that Blalock-Taussing operation is effective palliation for patients with cyanotic heart disease, especially with complex anomaly, with an acceptable mortality.