고혈압 의료비 지역 간 변이 및 변이 요인 분석

최순호,김유미,용왕식 한국디지털정책학회 2015 디지털융복합연구 Vol.13 No.10

대동맥판막 치환술의 임상성적

최순호,양현웅,김은규,최종범 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery Vol.31 No.6

Background: The aim of the current study was to analyze the early and intermediate-term performance of aortic valve replacement. Material and Method: Between January 1986 and January 1996, records of 61 consecutive patients who had received aortic valve replacement were reviewed. 38 were male and 23 were female patients, ranging from 10 to 71 years of age(mean: 40.5${\pm}$11.2). Results: The early death rate was 4.9%(3/61). A thorough follow-up rate of 93.1% was accomplished in these 58 patients who left the hospital(mean: 51.5${\pm}$32.0 patient-months) under the assistance of the same operator. Three of these patients who left the hospital died. The late death rate was 5.2%(3/58). Five patients experienced anticoagulant-related hemorrhage(all were minor). Three patients had thromboembolic episodes. There was no clinical evidence of hemolysis and structural failure of valves used. Of those patients who survived, the NYHA functional class improved significantly. Linearized rate were 1.58%/patient-year and 2.0%/patient-year respectively for thromboembolism and anticoagulant-related hemorrhage. The 10 year actuarial survival rate was 83.6%. Conclusion: This early and intermediate-term follow-up suggests that the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and low rate of prosthesis-related complication.

심장 수술후에 발생한 급성 폐동맥 고혈압및 우심부전증 환자에서 nifedipine의 효과

최순호,최종범,윤향석,Choe, Sun-Ho,Choe, Jong-Beom,Yun, Hyang-Seok 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery Vol.25 No.7

We report the successful use of Nifedipine in the treatment of acute pulmonary hypertension in an young child after a cardiac operation. This patient had undergone patch closure of large ventricular septal defect. She had signs of severe pulmonary artery hypertension unresponsive to hyperventilation, oxygenation, sedation, and a myriad of vas-oactive drugs. Nifedipine, 0.3mg /kg every 4 hours, effectively treated her pulmonary artery hypertension and allowed for a smooth postoperative course and positive outcome. The drug lowered systemic diastolic pressure, but not systolic pressure.

승모판 치환술에 관련된 좌심실 파열[2례]

최순호 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery Vol.25 No.6

Improving intraoperative and postoperative myocardial protection and better construction and design of valvular prosthesis has reduced the mortality of MVR. But, ventricular rupture after MVR occurred occasionally and represented a potentially lethal complication. Transverse midventricular disruption presented as refractory myocardial failure immediately on termination of bypass or later often on initial period of good hemadynamics. From Jan., 1985 through Dec., 1991 131 MVRs were performed as isolated or combined procedures. Rupture of the posterior wall of left ventricle was observed in 2 patients. There were 2 type III ruptures Prevention is of utmost importance, and by taking certain precautions, the chance of ventricular rupture can be reduced. Repair should always be done by patch technique in the aid of the use of cardiopulmonary bypass with cardioplegic arrest. When the laceration is in the middle of the posterior left ventricle, external repair with the pericardial patch can be attempted first.

선택적 심장수술 환자에서 고식적 혈액 보존방법

최순호 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery Vol.26 No.2

The risks of homologous blood transfusion are well documented and recently increased with the emergence of acquired immunodeficiency syndrome. This is a report concerning 29 consecutive adult with no blood conservation patients (Group I) who had an elective cardiac operations. A similar group of 29 patients operated on 1992 but with blood conservation (Group II). In I of Group I patients and 15 of Group II patients, no homologous blood products were required. Group II patients used significantly less fresh frozen plasma (2.05${\pm}$0.68 unit versus 6.52${\pm}$0.72 unit, p<0.05) and the homologous blood transfusion (0.42${\pm}$0.9 unit versus 3.64${\pm}$0.17 unit, p<0.05) than Group I patients. Group II patients had also significantly less postoperative bleeding (338${\pm}$39.9 ml versus 585${\pm}$93.0 ml, p<0.05) than Group I patients. Group II patients recieved 460${\pm}$62.6 ml of mediastinal shed blood in acquired group. In conclusion, a simple and inexpensive blood conservation program, mainly combining autologous blood removal before bypass, retransfusion of the volume remaining in the oxygenator, and consistent autotransfusion of mediastinal shed blood has enabled us to avoid infusion of homologous blood in 15/29 patients of Group II patients. No side effects or complicatinos could be related to the blood conservation program.

늑막강에서 기원한 악성 섬유성 조직구종 -치험 1례-

최순호,고광표,한재오,최종범 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery Vol.33 No.9

Primary malignant fibrous histocytoma(MFH) of pleura is very rare. Upon microscopic examination, the tumor was characterized by storiform pattern of growth and intense, diffuse immunostaining for $\alpha$ l-antichymotripsin. We report a case of primary malignant pleural fibers histiocytoma with extension to lung, which was managed by complete excision of pleural mass and lobectomy with thoracoplasty.

기계판막을 갖고있는 임산부에서 항응고요법

최순호,고광표,한재오,최종범,김경호 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery Vol.33 No.6

Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.

다중판막 치환술의 임상 성적

최순호,이삼윤,김형곤,Choe, Sun-Ho,Lee, Sam-Yun,Kim, Hyeong-Gon 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery Vol.28 No.4

Records of 71 consecutive patients who had received multiple valve replacement were reviewed[34male,37female,mean age 40.5$\pm$11.2 <14-63> . The early death rate was 2.8%[2/71 . A completed follow-up rate of 95.7% was accomplished in these 69 patients who left hospital[mean 42.5 $\pm$29.5 patients-years . Five of these patients died. The late death rate was 7.2%. Four patients experienced anticoagulant-related hemorrhage[all were minor . One patient had a thromboembolic episode[permanent ,and 2 had late prosthetic valve endocarditis. There was no clinical evidence of hemolysis and structural failure of valves used. Of those patients who survived,NYHA functional class improved significantly[from 87.2% class III & IV before to 95.8% class I & II after . Linearized rates for thromboembolism and anticoagulant-related hemorrhage,and for prosthetic valve endocarditis were 0.67%/100 patient-years,2.95%/100 patient-years,1.34%/100 patient-years, respectively. The actuarial estimates of incidence free of all complications and valve-related deaths were 92.2%/patient-years.Despites the advanced heart disease involving two or more native valves, the patients who had multiple valve replacement had very good results, over a 9-year period.

심내막염 환자의 수술적 치료성적

최순호,양현웅,이삼윤,Choe, Sun-Ho,Yang, Hyeon-Ung,Lee, Sam-Yun 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery Vol.29 No.2

Between January 1986 and June 1994, 23 patients underwent surgical intervention for infective endocarditis at Wonkwang University Hospital. There were 13 male and 5 female, ran ing in age from 13 to 67(mean 43.7 $\pm$ 5.8) years. 21 had native valve endocarditis and 2 had prosthetic valve endocardits. The most common causative organism was streptococci in 9 patients, and the others were staphylococci in 7 patients and unknown in 7 patients. The infection was in the mitral valve in 10 patients, the aortic valve in 6 patients, the aortic and mitral In 5 patients, 2 in tricuspid. Surgical indications for surgery were intractable congestive heart failure, giant growing vegetation and severe valvular insufficiency. There were 3 perioperative death (13%) and no late death. The main causes of death were cerebral embolism in 2 due to recurrent endocarditis and low cardiac output in 1. By NYHA functional classification, all patients were in class III or IV preoperatively, and all patients were improved postoperatively with HYHA functional classification in class I or II. In conclussion, early operative intervention is life-salving in patients with persistent or progres ive congestive heart failure, irrespective of the activity of the infectious process or the duration of antibiotic therapy.

요각류, Paracyclopina nana 대량배양과 명태 (Theragra Chalcogramma)자어에 대한 먹이 효율

최순호,김지환,이충일,박현제,변순규,최진,박흠기 한국수산과학회 양식분과 2019 한국수산과학회 양식분과 학술대회 Vol.2019 No.5