The Effect of Thoracoscopic Pleurodesis in Primary Spontaneous Pneumothorax: Apical Parietal Pleurectomy versus Pleural Abrasion

허업,김영대,조정수,이호석,이종근,이준호 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.5

Background: The standard operative treatment of primary spontaneous pneumothorax (PSP) is thoracoscopic wedge resection, but necessity of pleurodesis still remains controversial. Nevertheless, pleural procedure after wedge resection such as pleurodesis has been performed in some patients who need an extremely low recurrence rate. Materials and Methods: From January 2000 to July 2010, 207 patients who had undergone thoracoscopic wedge resection and pleurodesis were enrolled in this study. All patients were divided into two groups according to the methods of pleurodesis; apical parietal pleurectomy (group A) and pleural abrasion (group B). The recurrence after surgery had been checked by reviewing medical record through follow-up in ambulatory care clinic or calling to the patients, directly until January 2011. Results: Of the 207 patients, the recurrence rate of group A and B was 9.1% and 12.8%, respectively and there was a significant difference (p=0.01, Cox’s proportional hazard model). There was no significant difference in age, gender, smoking status, and body mass index between two groups. Conclusion: This study suggests that the risk of recurrence after surgery in PSP is significantly low in patients who underwent thoracoscopic wedge resection with parietal pleurectomy than pleural abrasion.

사선을 넘어서

허업 한신대학교 신학대학원 2002 세계와 선교 Vol.- No.182

Traumatic Peripheral Arterial Injury with Open Repair: A 10-Year Single-Institutional Analysis

조호성,허업,이충원,송승환,김선희,정성운 대한흉부외과학회 2020 Journal of Chest Surgery (J Chest Surg) Vol.53 No.5

Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center. Methods: Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications. Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient). Conclusion: Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.

Outcomes of Carotid Endarterectomy according to the Anesthetic Method: General versus Regional Anesthesia

김종원,허업,송승환,성상민,홍정민,조아름 대한흉부외과학회 2019 Journal of Chest Surgery (J Chest Surg) Vol.52 No.6

Background: The surgical strategies for carotid endarterectomy (CEA) vary in terms of the anesthesia method, neurological monitoring, shunt usage, and closure technique, and no gold-standard procedure has been established yet. We aimed to analyze the feasibility and benefits of CEA under regional anesthesia (RA) and CEA under general anesthesia (GA). Methods: Between June 2012 and December 2017, 65 patients who had undergone CEA were enrolled, and their medical records were prospectively collected and retrospectively reviewed. A total of 35 patients underwent CEA under RA with cervical plexus block, whereas 30 patients underwent CEA under GA. In the RA group, a carotid shunt was selectively used for patients who exhibited negative results on the awake test. In contrast, such a shunt was used for all patients in the GA group. Results: There were no cases of postoperative stroke, cardiovascular events, or mortality. Nerve injuries were noted in 4 patients (3 in the RA group and 1 in the GA group), but they fully recovered prior to discharge. Operative time and clamp time were shorter in the RA group than in the GA group (119.29±27.71 min vs. 161.43±20.79 min, p<0.001; 30.57±6.80 min vs. 51.77±13.38 min, p<0.001, respectively). The hospital stay was shorter in the RA group than in the GA group (14.6±5.05 days vs. 18.97±8.92 days, p=0.022). None of the patients experienced a stroke or restenosis during the 27.23±20.3-month follow-up period. Conclusion: RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay.

Comparison between Kissing Stents and Direct Surgical Bypass for Aortoiliac Occlusive Disease

이충원,허업,배미주,Han Changsung,권훈,김권민 대한심장혈관흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.4

Background: The optimal management strategy for aortoiliac occlusive disease (AIOD) remains debatable. This study compared early and late outcomes between direct surgical bypass and kissing stents for AIOD treatment. Methods: We retrospectively reviewed data, including age, sex, risk factors, comorbidities, symptoms, TransAtlantic Inter-Society Consensus (TASC) II classification, operation time, perioperative complications, in-hospital mortality, and length of hospital stay, from a cohort of 46 patients treated for AIOD (24 with kissing stents and 22 with direct surgical bypass) at Pusan National University Hostpital from January 2007 to December 2016. The primary, assisted primary, and secondary patency rates in both groups were compared. Results: The hospital stay (direct surgical bypass vs. kissing stents: 16.36±5.19 days vs. 9.08±10.88 days, p=0.007) and operation time (direct surgical bypass vs. kissing stents: 316.09±141.78 minutes vs. 99.54±37.95 minutes, p<0.001) were significantly shorter for kissing stents. Kaplan-Meier analysis revealed that the primary, assisted primary, and secondary patency rates in the direct surgical bypass group were 95.5%, 95.5%, and 95.5%, respectively, at 1 year; 86.4%, 86.4%, and 95.5% at 3 years; and 77.3%, 77.3%, and 95.5% at 5 years. The primary, assisted primary, and secondary patency rates in the kissing stent group were 100.0%, 100.0%, and 100.0%, respectively, at 1 year; 95.8%, 95.8%, and 100.0% at 3 years; and 95.8%, 95.8%, and 100.0% at 5 years. Conclusion: Except for special cases wherein endovascular revascularization is difficult, kissing stents are more advantageous for TASC II C and D lesions.

섬유강화 고분자 복합판의 기계적 성질에 미치는 섬유길이와 섬유함유율의 영향

이상동,김혁,허업,최종대,이동기 조선대학교 에너지.자원신기술연구소 1997 에너지·자원신기술연구소 논문지 Vol.19 No.2

This paper describes effect of chopped strand length fiber content and moisture absorption on mechanical properties of fiber-reinforced polymeric composites. It was extrusion compounded long fiber-reinforced polypropylene containing 20, 30 and 50 percent and short fiber-reinforced ABS and PAS containing 30 percent b37 the weight of glass fiber. The test methods of ASTM D638, D3410-87 and D79OM are applied for tensile, compressive and bending tests respectively. The results show that, in the case of 0.2% moisture absorption, the residual strength decreases dramatically.

혈관내 풍선 확장에 의한 대동맥 차단소생술이 적용된 돼지 복부 장기 조직의 기계적 거동 평가

왕일재,유지훈,허업,송승환,안효영,송찬희,이치승,유동만,Wang, Il Jae,You, Ji-Hun,Huh, Up,Song, Seunghwan,Ahn, Hyo Young,Song, Chan-Hee,Lee, Chi-Seung,Ryu, Dong-Man 한국재료학회 2020 한국재료학회지 Vol.30 No.4

Abdominal organs are the most vulnerable body parts under vehicle trauma, and there is high mortality from acute injuries in accidents. There are various ways to reduce this high mortality; one method is Resuscitative Endovascular Balloon Occlusion of the Aorta, which has recently become very popular as a minimally invasive alternative in the emergent management of patients with non-compressible hemorrhages below the diaphragm. However, high safety factor for patients is applied in actual clinical practice because there is no exact standard for the operating time. Therefore, in this study, the effects of the mechanical behavior of organ tissues for the duodenum, kidney, and liver on the operating time of Resuscitative Endovascular Balloon Occlusion of the Aorta is investigated in order to obtain data needed to establish standards of operating time. In characteristic analysis of organ tissues, uniaxial tensile test and compression test are conducted according to the operating time.

복부대동맥류 형상 및 연령에 따른 동맥 벽 응력 특성 및 파열 위험성 평가

이충원,유지훈,허업,이치승,유동만 한국전산구조공학회 2020 한국전산구조공학회논문집 Vol.33 No.3

In this study, the wall stress and rupture risk for abdominal aortic aneurysms were calculated based on the age and geometry of the examined abdominal aortic aneurysms. The geometry of the abdominal aorta was simulated using computed tomography data from patients with abdominal aortic aneurysms. With regard to material properties, the Gasser-Ogden-Holzapfel model was applied to the analysis to simulate the anisotropic hyperelastic characteristics of the artery. In addition, each material parameter was estimated to consider the properties for age and for normal and aneurysm tissue. Moreover, the correlation between the diameter and angle of the aortic aneurysms was analyzed based on data from patients with abdominal aortic aneurysms, and series simulations were conducted. As a result, the rupture risk for the abdominal aortic aneurysms was evaluated based on the age and geometry of the aneurysm. 본 연구에서는 복부대동맥류가 발생한 환자들에서의 연령과 복부대동맥류 형상에 따른 벽 응력과 파열 위험성을 평가하였다. 복부대동맥류의 형상은 의료영상 데이터로부터 추출되어 모사되었으며, 재료 물성치 단계에서는 동맥 조직의 이방성 초탄성 성질을 모사하기 위해 Gasser-Ogden-Holzapfel 모델을 적용하였다. 또한, 모델에서 필요한 각 재료 정수들은 환자들의 연령과 정상 조직 및 동맥류 조직의 특성들을 고려하기 위하여 각기 다른 값들로 산정되었다. 게다가 복부대동맥류에서의 대동맥 직경과 목의 각도에 관한 상관관계를 분석하고, 이에 대한 시리즈 시뮬레이션 역시 수행되었다. 그 결과, 복부대동맥류 환자의 연령과 대동맥 직경, 그리고 대동맥 목의 각도에 따른 복부대동맥류의 파열 위험성이 평가되었다.

Should We Remove the Retrievable Cook Celect Inferior Vena Cava Filter? Eight Years of Experience at a Single Center

손주형,배미주,정성운,이충원,허업,송승환 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.6

Background: The inferior vena cava filter (IVCF) is very effective for preventing pulmonary embolism in patients w ho cannot u ndergo a nticoagulation t herapy. However, if a f ilter i s placed i n the body permanently, i t may lead to other complications. Methods: A retrospective study was performed of 159 patients who underwent retrievable Cook Celect IVCF implantation between January 2007 and April 2015 at a single center. Baseline characteristics, indications, and complications caused by the filter were investigated. Results: The most common underlying disease of patients receiving the filter was cancer (24.3%). Venous thrombolysis or thrombectomy was the most common indication for IVCF insertion in this study (47.2%). The most common complication was inferior vena cava penetration, the risk of which increased the longer the filter remained in the body (p=0.032, Exp(B)=1.004). Conclusion: If the patient is able to retry anticoagulation therapy and the filter is no longer needed, the filter should be removed, even if a long time has elapsed since implantation. If the filter c annot be r emoved, it i s recommended t hat follow-up c omputed tomography b e performed regularly to monitor the progress of venous thromboembolisms as well as any filter-related complications.

Videoscopic Surgery for Arteriovenous Hemodialysis Access

정현철,배미주,정성운,이충원,허업,김민수 대한흉부외과학회 2020 Journal of Chest Surgery (J Chest Surg) Vol.53 No.1

Background: When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions. Methods: Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed. Results: Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days). Conclusion: Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.