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      • SCOPUSKCI등재

        급성 심근경색에 합병된 심실중격 결손증의 수술적 치료: 1례 보고

        황석하 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.4

        Post-AMI VSD is an infrequent but often catastrophic complication of acute myocardial infarction In general, the mortality is associated with end organ failure due to low output syndrome. Therefore, a stable hemodynamic is necessary to prevent the end organ failure. If a supportive therapy does not accomplish it, surgical intervention should be considered. Recently, we have experinced a case of post-AMI VSD with cardiogenic shock. Early recognition and surgical repair of post-AMI VSD gave us a good result. Postoperative result was satisfactory and recovery was uneventful. We believe that early surgical repair can be lifesaving in the case of post-AMI VSD with cardiogenic shock.

      • SCOPUSKCI등재

        개심술시 CK-MB치 변화 [심근보호]

        황석하 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.12

        Possible enhancement of myocardial protection with oxygenated crystalloid cardioplegia and blood cardioplegia were evaluated in a cardiac enzyme study. The bicarbonate-containing solution equilibrated with 100% oxygen becomes highly alkaline as carbon dioxide is released. 95% oxygen and 5% carbon dioxide was added to the crystalloid cardioplegic solution[St. Thomas` Hospital No. 2 Solution] for prevention of severe alkalinity of oxygenated crystalloid cardioplegia. Heart was arrested and reinfused every 20 minutes throughtout the ischemic period with crystalloid cardioplegia or oxygenated crystalloid cardioplegia or blood cardioplegia. Group I was a patient with crystalloid cardioplegia in 11 patients. Group II was a patient with oxygenated crystalloid cardioplegia in 9 patients. Group III was a patient with blood cardioplegia in 15 patients. The value of CK-MB was evaluated from the patient`s serum at 6 hours, 24 hours, and 48 hours postoperatively.In Group I and II, there was no significant change of CK-MB. In Group I and 11I, the value of CK-MB at postoperative 6 hours was 114 + 83 ng/ml and 56 + 22 ng/ml [P [0.05]. In conclusion, blood cardioplegia was superior to crystalloid cardioplegia.

      • KCI우수등재
      • KCI등재

        심한 골다공증 환자에서 발생한 척추체 압박골절에 대한 주 단위 테리파라타이드(Teriparatide)의 투여 효과

        황석하,우영균,전호승,서승표,김주영,김재남 대한정형외과학회 2019 대한정형외과학회지 Vol.54 No.6

        Purpose: This study examined the effects of a weekly teriparatide on the change in vertebral compression ratio, back pain, and vertebral fracture healing in osteoporosis patients with vertebral compression fractured induced by low energy trauma. Materials and Methods: From January 2016 to December 2017, 57 patients with severe osteoporotic vertebral fractures with a T score of -3.5 or less were included in this study. The changes in the vertebral compression ratio, visual analogue scale (VAS), Oswestry disability index (ODI) for at least 6 months were examined. The morphology of bone marrow edema and the presence of intervertebral cleft, osteocalcin, and N-terminal telopeptide (NTx) were also investigated. Results: The mean compression ratio was 20% in the experimental group (teripratide group) at 3 months, and 38% in the control group. A significant difference in the compression ratio of the vertebral body over time was observed (p<0.05; t-test). A comparison of the compression ratio of the vertebral body with the follow-up duration in each group showed no significant increase in the, compression (p=0.063) in the experimental group and a significant increase in the control group (p<0.05). The mean time to reach the plateau of the compression rate was one month in the experimental group and three months in the control group. The VAS score in the experimental and control group was 0.39 and 1.07 points, respectively. The ODI score in the experimental and control group was 33.72 and 39.52, respectively. At the last follow-up radiographs, there were no cases with an intervertebral cleft (0%) in the experimental group and 1 case (2.2%) in the control group. A significant difference in the osteocalcin level was observed between the injury and 6 months after the injury (p=0.003). In addition, there was no significant difference in the NTx level between the injury and 6 months after injury (p=0.960). Conclusion: In vertebral compression fractures patients with severe osteoporosis, a weekly teriparatide can promote the union of fractures, prevent further collapse of the vertebral body, and reduce the back pain faster. 목적: 저에너지 손상에 인한 척추체 압박골절이 발생한 골다공증 환자들에서 척추체 압박률의 변화, 요추부 동통 및 척추체 골절 치유에 테리파라타이드가 미치는 영향을 알아보고자 하였다. 대상 및 방법: 2016년 1월부터 2017년 12월까지 골밀도 검사상 T 점수가 -3.5 이하인 심한 골다공증성 척추 압박골절 환자 57명을 대상으로 하였다. 최소 6개월간 척추체 압박률의 변화, 시각통증지수(visual analogue scale, VAS) 및 Oswestry disability index (ODI)를 조사하였고 수상 후 자기공명영상에서 손상된 척추체의 골수 부종의 형태, 최종 추시 방사선 사진에서 추체내열의 유무, osteocalcin, N-terminal telopeptide (NTx) 등 골 형성 표지자의 변화 및 실험군 및 대조군에서 인구통계적 차이를 조사하였다. 결과: 실험군(테리파라타이드군)에서 3개월 후 평균 압박률은 20%, 대조군에서 38%였고 시간에 따른 척추체 압박률 변화에서 유의한 차이가 있었다(p<0.05; t-test). 각 군 내에서 추시 기간에 따른 척추체 압박률의 변화 정도를 비교하였을 때 실험군에서는 척추체 압박률이 유의하게 증가하지 않았으며(p=0.063), 대조군에서는 유의하게 증가하였다(p<0.05). 척추체의 평균 압박률이 변화하지 않는 평형기에 도달하는 시기는 실험군에서 1개월, 대조군에서 3개월이었다. 실험군에서 VAS가 0.39점, 대조군에서 1.07점으로 실험군에서 VAS의 호전 정도가 우수하였다. 실험군에서 ODI가 33.72점, 대조군에서 39.52점으로 실험군에서 ODI가 우수하였다. 최종 추시 방사선 사진에서 추체내열이 있는 증례가 실험군에서는 없었고(0%), 대조군에서는 1명이었다(2.2%). 실험군에서 osteocalcin 평균은 수상 직후 17.15 ng/ml, 6개월 후 24.20 ng/ml로 유의한 차이가 있었으며(p=0.003), NTx 평균은 수상직후 49.54 nMBCE/mMCr, 6개월 후 49.98 nMBCE/mMCr로 유의한 차이가 없었다(p=0.960). 결론: 심한 골다공증 환자에서 발생한 척추체 압박골절의 치료 약제로서 주 단위 테리파라타이드는 골절의 유합을 촉진하여 척추체 붕괴를 방지하며 요추부 동통을 더 빠르게 경감시킨다.

      • KCI등재

        A Case of Full-mouth Rehabilitation using a Digital twin Based on Multi-source Data in a Patient with Vertical Dimension Loss due to Multiple Tooth wear and Fractures

        황석하,박지만,김장현,심준성,정우선 대한구강악안면임플란트학회 2022 대한구강악안면임프란트학회지 Vol.26 No.3

        Abrasion, fracture, and absence of multiple teeth can occur owing to various causes. In the case of generalized wear, the inherent vertical dimension is lost, and tooth-supported or implant-supported fixed prosthetic restorations are considered as treatment alternatives. Any treatments planned on an articulator should be reproduced in patients without any errors. After verification, the final prosthesis should be fabricated. In the traditional method, this process is complicated, with theoretical and technical challenges to be overcome by practitioners. However, with the development and introduction of digital workflows as a treatment method, full-mouth rehabilitation is no longer a burdensome and challenging procedure. In this case report, full-mouth rehabilitation was performed in a 56-year-old male patient with loss of vertical dimension using a digital workflow different from the conventional method. Digital data, such as from intraoral and facial scans, CBCT, and jaw motion data, were acquired and used. Full-mouth rehabilitation was performed through case analysis, treatment plan establishment, prosthesis design, and digital manufacturing in digital twins created through the integration of various digital data.

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