心室中隔缺損孔閉鎖術後에 發生한 左脚前枝불록을 同伴한 右脚불록, 完全房室불록 및 房室解離에 關한 心電圖學的 硏究

蔡憲 최신의학사 1981 最新醫學 Vol.24 No.7

흉부외상에 의한 하행흉부대동맥파열 (수술 치험 1예 보고)

채헌,노준량,Chae, Hurn,Rho, Joon-Ryang 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.1

A successful repair of transected descending thoracic aorta was performed in a 44-year-old man. The patient had once been hospitalized in a local clinic for 7 days after a steering wheel injury. Dealing with right Colle`s fracture, he was transferred to this hospital to rule out aortic injury. On admission, a chest PA film and concomitant aortogram revealed an aneurysm of the descending thoracic aorta just distal to the origin of the left subclavian artery measuring 6 cm in diameter and 8 cm in length. He underwent urgent thoracotomy and the injured part of the aorta was replaced with a woven Dacron graft utilizing a Gott`s heparinized aortic shunt. The postoperative course was very smooth except hoarseness and left phrenic nerve palsy due to a blind clamping of the proximal aorta during the operation.

체외순환에 의한 혈청 Magnesium의 변화

채헌,노준량,서경필,이영균,Chae, Hurn,Rho, Joon Ryang,Suh, Kyung Phill,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

Alterations in the serum magnesium level were studied in twenty patients who had open-heart surgery during the period from August 1974 to May 1975. The patients were chosen at random. The operative procedures included repair for congenital heart diseases in fifteen patients and cardiac valve replacement for acquired valvular heart diseases in five patients. The age ranged from 8 to 46 years, with an average of 19 years. None of the patients had a history of gross neuromuscular abnormalities. Cardiopulmonary bypass was carried out using a roller pump and a disposable oxygenator. The prime solution consisted of 2 units of ACD banked blood and approximately an equal volume of non-blood additives in adults, while a relatively smaller volume was added in children. The average flow rate was 2,733 ml per minute. Blood samples for magnesium and arterial blood pH were obtained the day after admission 25 minutes after initiation of the bypass and on the morning the day after operation. Preoperative data were then compared with those obtained during the bypass and postoperatively by a paired test. During the bypass, the serum magnesium level decreased significantly from $1.425{\pm}0.029$ to $1.210{\pm}0.063mEq.$ liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter postoperatively (p<0.01). The duration of bypass was less than 90 minutes in 10 patients (group A) and exceeded 90 minutes in the remaining 10 (group B). There was no statistical correlation between the groups A and B ($p{\gg}0.20$). Statistical analyses of the serum magnesium level and arterial blood pH showed no significant correlation with correlation coefficient; being -0.3485(pre-op), -0.2971(during bypass), and -0.1008(post-op), respectively. In all the patients, no gross neuromuscular abnormalities were found postoperatively. At present, the clinical significance of the serum magnesium level during and after bypass is controversial. In the near future, however, it is expected that improvements in prime solution and heart-lung machine will solve this problem.

혈관질환의 외과적 고찰

채헌,이영,노준량,김종환,서경필,이영균,Chae, Hurn,Lee, Young,Rho, Joon Ryang,Kim, Chong Whan,Suh, Kyung Phill,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.1

One hundred and seventy-four patients were treated in this Department since 1956. One hundred and fifteen patients of them were surgically treated. They were classified on the basis of the disease entity as follows; 48 case of thrombo-angiitis obliterance, 8 cases of Leriche syndrome, 12 cases of arterial embolism, 36 arterial aneurysm, 5 arterio-venous fistula, 15 arterial and venous injuries, 8 pulseless diseases, 2 coarctation of aortas, 15 varicose veins, 12 thrombophlebitis, 9 superior venacaval syndromes, 2 inferior vena caval obstructions and Raynaud's diseases. All the cases of the Burger's diseases were males, and half of them were in the fourth decades, 39 cases underwent undergone unilateral or bilateral sympathectomies. All the Leriche syndromes were males aged over fifty. Three cases out of six were suffering from diabetes mellitus. 2 cases underwent aorto-femoral bypass graft with Y-shaped dacrons. And two embolectomies were performed in 2 cases. Eight cases of arterial embolisms among 12 had mitral valvular diseases with auricular fibrillation The most common site of lodgement of emboli was femoral artery. Nine out of 14 underwent embolectomies with Fogarty catheters. There were 14 peripheral arterial aneurysms, 16 thoracic and/or abdominal aortic aneurysms, and 4 dissecting aneurysms. Most frequent cause of peripheral arterial aneurysms were external trauma. Thoracic and abdominal aortic aneurysms were non-traumatic. And four cases of the dissecting aneurysms had significant hypertension and aged over fifty. Among 5 cases of arteriovenous fistulas, 2 cases hand typical Branham's sign, and they were normalized after operation. Eight cases of pulseless disease were females and aged from three to twenty-five. Three out of them were treated surgically using dacron prosthetic grafts, but the results of the surgery were variable and not satisfactory. A case of coarctation of aorta was treated surgically with an excellent result. Fourteen out of 15 varicose veins underwent ligation of the saphenous vein system, exstirpation of the varicose veins, stripping or some combination of these methods. Two cases of superior vena caval syndromes were operated by bypass graft between the left innominate vein and the right auricle. Two cases of inferior vena caval obstructions were operated upon through right atrial route using extracorporial circulation. All the four cases of vena caval obstructions showed excellent results postoperatively. Two cases out of 12 thrombophlebitis underwent thrombectomies. One of two Raynaud's diseases was surgically treated with an excellent result.

경북과 충남지역 중견기업의 기업특성, 무형자산투자활동 및 재무지표가 경영성과에 미치는 영향 비교

채헌,김대철 한국재정정책학회 2022 財政政策論集 Vol.24 No.1

The purpose of this study is to present a development strategy for mid-sized companies that meet the economic conditions of Gyeongbuk by analyzing how the corporate characteristics, intangible asset investment activities and financial indicators affect management performance of mid-sized companies in Gyeongbuk and Chungnam. As a result of empirical analysis after building panel data by combining registered mid-sized companies and KIS databases, mid-sized companies in Chungnam from 2014 to 2019 showed relatively better management performance than in Gyeongbuk. In this respect, it can be inferred as one factor that has shown a difference in economic growth between the two regions since the 2000s, so it is necessary to further foster good mid-sized companies in Gyeongbuk. In addition, in the case of manufacturing mid-sized companies in Gyeongsangbuk-do, debt ratio and borrowing ratio had a significant positive effect on management performance, so policy authorities should help mid-sized companies survive in the region through various financial support in response to the COVID-19 situation. Finally, from the results of the R&D intensity of mid-sized Chungnam companies having a greater impact on the management performance of mid-sized Chungnam companies, cooperation with local SMEs should be strengthened and corporate innovation capabilities should be strengthened. Specifically, it is necessary to actively attempt win-win cooperative R&D investment with local SMEs and make more active efforts in introducing overseas technologies, international diversification, and overseas investment. 본 연구는 경북과 충남 중견기업의 기업특성, 무형자산투자활동과 재무지표가경영성과에 어떤 영향을 미치고 있는가를 분석하여 경북지역의 경제적 여건에맞는 중견기업의 발전전략을 제시하였다. 등록 중견기업과 기업신용정보 데이터베이스를 결합하여 패널데이터를 구축한 후 실증분석 결과, 2014∼2019년 충남중견기업의 경영성과가 상대적으로 경북보다 양호한 것으로 나타났다. 이런 측면에서 2000년대 이후 두 지역의 경제 성장도에서 차이를 보인 하나의 요인으로 유추할 수 있으므로 경북에서도 경영성과가 우수한 중견기업을 더욱 육성할 필요가 있다. 또한 경북의 제조 중견기업의 경우 부채비율과 차입금비율이 경영성과에 유의한 긍정적인 영향을 주었기 때문에 코로나19 상황에 부응하여 정책당국은 다양한 금융지원을 통해 지역에서 중견기업이 생존할 수 있도록 도와야 할것이다. 마지막으로 충남 중견기업의 연구개발집약도가 충남 중견기업의 경영성과에 더 큰 영향을 준 결과로부터 지역 중소기업과의 협력을 강화하고 기업 혁신역량을 강화해야 한다. 구체적으로 지역중소기업과의 상생협력형 R&D투자를 적극 시도하고 해외기술 도입, 국제다각화, 해외투자에 보다 더 적극적인 노력이 필요하다.

관상동맥우회술 환자에서의 심근관류점수제에 대한 연구: 완전혈관재생술의 평가

채헌,백완기,안혁,김용진,노준량,김종환,서경필,Chae, Hurn,Baek,Wan-Ki,Ahn, Hyuk,Kim, Yong-Jin,Rho, Joon-Ryang,Kim, Chong-Whan,Suh, Kyung-Phill 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.9

The ideal goal of the coronary artery bypass surgery is complete revascularization. To estimate the numerical degree of completeness of revascularization, the following formula was used in 50 patients having aorta-coronary bypass grafting for the treatment of unstable angina. myocardial perfusion score of revascularized area Degree of Completeness = ----------------------------------------------------------------------------- x100[%] preoperative myocardial perfusion score Randomized patients who underwent revascularization procedures in 19Hb were compared with the patients who received similar elective operation each year from 1988 through 1991. To obtain these data, the patients aged 38 ~ 75[mean 54$\pm$9.1years], composed of 31 males and 19 females were randomly sampled. The number of grafts per patient increased from 2.30 in 1986, to 3.07 in 1988 - 89, to 3.21 in 1990, and to 3.50 in 1991. [0.05 The degree of completeness improved from 75.4% to 81.4%, 91.6% and 88.6% respectively. It improved significantly in the last two years, [P<0.05, Mann-Whitney U test] At a follow-up of three months, 90 percent[45/50] of patients remained angina, free, 6 percent[3/50] had residual angina, and 4 percent[2/50] died. The last two patients degree of completeness corresponded to 43% and 30% respectively As a conclusion, the degree of completeness seems to improve year by year, and to have close relationship with the clinical results.

판막 이식수술후의 각종 항응고제 사용에 관한 비교적 연구 - 조직판막 이식수술후 Warfarin 사용군과 antiplatelet 사용군과의 비교 -

채헌,박영관,서경필,Chae, Hurn,Park, Young-Kwan,Suh, Kyung-Phill 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.1

To clarify the difference between the outcome of warfarin anticoagulation and the antiplatelet [Aspirin, Dipyridamole] therapy after bioprosthetic heart valve replacement, we compared the following two groups. Group I [Warfarin group] consisted of 557 patients undergone lonescu - Shiley valve replacement between January, 1979 and December, 1985, and treated with scheduled warfarin therapy at Seoul National University Hospital. Group II [Antiplatelet group] consisted of 128 patients undergone lonescu - Shiley, Carpentier - Edwards or Wessex bioprosthetic valve replacement between March, 1983 and December, 1986, and treated primarily with antiplatelet therapy [Aspirin plus Dipyridamole] at SeJong General Hospital. The two groups were similar with respect to age, number of valves utilized per patient, type of operation and risk factors of thromboembolism. In group I, 522 patients excluding 35 hospital death [hospital mortality 6.3%], and in group II, 119 survivors excluding 9 hospital death [hospital mortality 7.0%] were followed. In group I, there were 13 fatal complications, of which seven were thromboembolic [0.6% / pt-yr] and six hemorrhagic [0.5%/pt-yr] during the period of four years. In group II, there were 3 fatal thromboembolic complications [2.3%/pt-yr] during the period of four years. This showed no statistically significant difference. Apart from fatal complications, there were lots of warfarin related minor complications in group I comparing with those of group II. The actuarial probability of the freedom from thromboembolism and of the freedom from fatal complications were very similar at each corresponding years postoperatively. As a result, warfarin anticoagulation in patients with bioprosthetic valve replacement did not reveal any significant advantages over antiplatelet therapy.

한국인의 관상동맥질환에 대한 병태해부학적 연구

채헌,Chae, Hurn 대한흉부심장혈관외과학회 1989 Journal of Chest Surgery (J Chest Surg) Vol.22 No.3

Forty cases of coronary artery bypass grafting treated at the Department of Thoracic and Cardiovascular Surgery, SNUH, Korea were compared with forty cases of the procedure treated at University of Alberta Hospital, Canada, in terms of pathoanatomy. That showed no difference in sex ratio between Korean and Caucasian the average ages, however, were 50.4 years and 60.9 years respectively [p< 0.005]. The leading cause of angina at presentation was unstable angina in Korean, but it was post-infarction angina in Caucasian instead. The incidences of single-vessel disease and double-vessel disease were similar in both countries, but the incidence of so-called triple-vessel disease was higher in Caucasian while left main coronary artery disease was more prevalent in Korean [0.01< P, 0.005]. < The internal diameters of surgically available coronary artery branches had similar characteristics and no significant statistical differences were found between them. The predilection sites of stenoses were proximal left anterior descending artery, left main coronary artery, proximal left circumflex artery and proximal right coronary artery decreasing in incidence respectively, in Korean. The myocardial perfusion score were 6.80 in single-vessel disease, 7.56 in double-vessel disease, 11.27 in triple-vessel disease and 9.77 in left main disease respectively, in Korean.

심실중격결손증의 임상적 고찰

채헌,서경필,이영균,Chae, Hurn,Suh, Kyung-Phill,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1975 Journal of Chest Surgery (J Chest Surg) Vol.8 No.1

Twenty-nine cases of ventricular septal defect operated in this department during the period from 1969 to May 1975 were presented. Out of 29 cases, there were 20 cases of type II defects, 8 cases of type I, and one case of type III, and the last case was multiple defect. The anomalies associated with ventricular septal defect were eight in all; three patent ductus arteriosus, one atrial septal defect, one tricuspid insufficiency and an aortic insufficiency. Over all mortality was 17%. The causes of death were complete heart block in a case, respiratory distress due to excessive administration of morphine in one, low cardiac output in two and perforation of the aortic annulus after repair of the ventricular septal defect associated with aortic insufficiency.

토끼 동방결절 박동수에 대한 아데노신의 작용

채헌,서경필,김기환,Chae, Hurn,Suh, Kyung-Phlill,Kim, Ki-Whan 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.2

The inhibition/influences of adenine compounds on the heart have been described repeatedly by many investigators, since the first report by Druny and Szent-Gyorgyi [1929]. These studies have shown that adenosine and adenine nucleotides have an over-all effect similar to that of acetylcholine [ACh] by slowing and weakening the heartbeat. The basic cellular and membrane events underlying the inhibitory action of adenosine on sinus rate, however, are not well understood. Furthermore, the physiological role of adenosine in regulation of the heartbeat remains still to be elucidated. Therefore, this study was undertaken in order to examine the response of rabbit SA node to adenosine and to compare the response to that of ACh. Isolated SA node preparation, whole atrial pair, or left atrlal strip was used in each experiment. Action potentials of SA node were recorded through the intracellular glass microelectrodes, which were filled with 3M KCI and had resistance of 30-50 M. All experiments were performed in a bicarbonate-buffered Tyrode solution which was aerated with 3% $CO_2-97%$ $O_2$ gas mixture and kept at $35^{\circ}C$. Spontaneous firing rate of SA node at 35C [Mean + SEM, n=16] was 154 + 3.3 beats/min. The parameters of action potentials were: maximum astolic potential [MDP], -731.7mV: overshoot [OS], 9 + 1.4mV; slope of pacemaker potential [SPP], 94 3.0mV/sec.Adenosine suppressed the firing rate of SA node in a dose dependent manner. This inhibitory effect appeared at the concentration of $10^{-6}M$ and was potentiated in parallel with the increase in adenosine concentration. Changes in action potential by adenosine were dose-dependent increase of MDP and decrease of SPP until $10^{-4}$. Above this concentration, however, the amplitude of action potential decreased markedly due to the simultaneous decrease of both MDP and OS. All these effects of adenosine were not affected by pretreatment of atropine [2mg/l] and propranolol [$5{\times}10^{-6}M$]. ACh [$10^{-6}M$] responses on action potential were similar to those of adenosine by increasing MDP and decreasing SPP. These effects of ACh disappeared by pretreatment of atropine [2mg/1]. Inhibition/effects of adenosine and ACh on sinus rate were enhanced synergistically with the simultaneous administration of adenosine and ACh. Marked decrease of overshoot potential was the most prominent feature on action potential. Dipyridamole [DPM], which is known to block the adenosine transport across cell membrane, definitely potentiated the action of adenosine . Adenosine suppressed the sinus rate and atrial contractility in the same dosage range, even in the reserpinized preparation. Above` results suggest that adenosine suppresses pacemaker activity, like ACh, by acting directly on the membrane of SA node, increasing MDP and decreasing SPP.