관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

완전 방실차단을 동반한 급성 심근염

이유선,정진옥,박용규,박형서,노상필,정승현,김정희,이재환,최시완,성인환 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

급성 심근염환자에서 발행한 완전 방실차단을 영구 심장박동 조율기로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Myocarditis, an inflammatory process involving the myocardal wall, may be caused by most infectious agents. Irrespective of its etiology, it presents commonly with evidence of heart failure, hypotension, and various electrocardiographic abnormalities. Patient with myocarditis may be asymptomatic or may have a rapidly progressive fatal disease. Medical management of patients with myocarditis includes specific therapy for underlying infection and control of the complication of myocarditis such as congestive heart failure and arrhythmia. Recently we had experienced myocarditis with complete atrioventricular block in 37-year-old man. Although he had shown complete recovery of heart failure, he had shown complete atrioventricular block, so we inserted permanent pacemaker. We report it with review of the literature.

대학생의 자기 긍정감, 자기 복잡성 및 우울 성향과의 관계

김완일,김재환 漢陽大學校 學生生活硏究所 1992 大學生活硏究 Vol.10 No.-

The purpose of this study was to examine how self-concepts(self-positivity and self-complexity) influence depression. Beck Depression Inventory, Self-positivity Scale, and Self-complexity Scale were administered to 372 college students. The results were as follows. The low group in self-positivity was more depressive than the high group in self-complexity was more depressive than the low group. Also, the neutral group in self-positivity was different in depression from self-complexity, but the high group in self-positivity was not different in depression from self-complexity. Finally, positive self-positivity and negative self-complexity were significantly correlated with depression.

영해의 법리와 군사 경계 수역에 관한 연구

하재환 釜山敎育大學 1978 부산교육대학 논문집 Vol.14 No.1

Nowadays the Korean peninsula is continuing the cessation of hostilities depending on a conclusion of "Agreement Concerning A Military in Korea, pannmunjon, july 27, 1953. From a principle of a truce of view, the cessation of hostilities is not a peace itself and it is very distinct that it doesn't mean the termination of the war. As a matter of fact, continuation of the cessation of hostilities between The Republic of Korea and The authority of North Korea depends materially on the power of military affairs rather than the establishment of institutions. And The Authority of North Korea recently set up and promulagated, authenticating in no provision of agreement concerning a military armistice, military warning area in the sea holding the significance of military affairs and economic zone being vested with the national sovereignty as well as the frequent use of armed forces in the sea. We can advocate that such a measurement intimidates subject matter which Five islands groups of Paengyong-Do, Taechong-Do, Yongpyong-Do and U-Do to the yellow sea are particulary under the military controls of the commander-in-chief, United Nations Command according to article 2 paragraph 13 of Agreement Concerning A Military Armistice in Korea. 1953 and implies disaffirmation of the facts that the authority of North Korea has observed provisions of the agreement above since 20 years after its contracting. Strictly speaking, it is very clear that the sea belt of these island mentioned is completely situated at a distance exceeding the width of the territorial sea to the side of the authority of North Korea. Every island, however exceedingly small an island may be, keeps the sea belt of the territorial sea by the examination of general reles of international law. The reason is on the grounds of the fact adopted in article 10 paragrph 2 of Convention on the Territorial Sea and the Contiguous Zone, 1958. Now that all the island hold its own territorial sea on the bases of general rules of international law and Geneva Convention, in plain terms Five islands group mentioned to the yellow sea hold its own territorial sea. The Authority of North Korea, accordingly, has the advocacies of no legal ground and is not endorse wholly. The illegality of the Authority of North Korea can be distinctly approved in the light of the Conventions and the principles of the international law.

平肺湯이 Oleic acid로 誘發된 家犬의 急性 肺水腫에 미치는 영향

鄭在雨,韓相桓 圓光大學校 韓醫學硏究所 1992 원광한의학 Vol.2 No.1

Certain oriental medication have been shown to be effective in decreasing pulmonary vascular resistance and increasing cardiac output in primary pulmonary artery pressure secondary to pulmonary edema. So oleic acid was administered in 14 dogs in order to induce acute lung injury. And we studied the hemodynamecs and blood gas changes of Pyengpaetang(平肺湯) (50mg, 100mg) with continuous postive pressure was ventilation iv pulmonary edema. The pulmonary edema group, arterial oxygenation was improved after 5 and 10 cm H_2O PEEP (positive end expiratory pressure), but cardiovascular system was depressed. Blood pressure and cardiac output were decreased, and CVP, MPAP, PCWP were increased. In Pyengpaetang(50mg) group, mena aortic pressure was decreased and PCWP(pulmonary capillary wedge pressure)was decreased remarkably, while there was a significant increase in cardiac output. And there was improvement in PaO_2 and PaCO_2 without hemodynamic changes after applying 5 cm H_2O PEEP, but arterial blood gases (PaO_2, PaCO_2) were improved, while cardiovascular effects were depressed after 10cm H_2O PEEP. In Pyengpaetang (100mg) treated group, there was no significant hemodynamic change. But mena pulmonary arterial pressure was signifiacntly increased, and cardiac output was decreased signifiacntly after applying the more degree of PEEP. And blood gases were not changed significantly after applying the more degree of PEEP. The above results suggest that the effects of Pyengpaetang (50mg) group is superior to those of Pyengpaetang(100mg) group on the effects of himodynamics and gas exchanges in acute lung injury in dogs. So we can conclude that lower degree PEEP 5cm H_2O is more beneficial in Pyengpaetang (50mg) treated group.

고순도 투광성 알루미나 Yarn Guide의 제조 및 특성

이승환,나상웅,이재형 영남대학교 공업기술연구소 2000 工業技術硏究所論文集 Vol.28 No.1

High purity translucent alumina yam guides were fabricated by injection molding. The green density was 54% of the theoretical after injection molding and debinding. Heat treatment in an argon atmosphere at 1750℃ for 5h to obtain translucency resulted in huge grain sizes in the specimens. Therefore, isostatical hot pressing was necessary for translucency and fine microstructure. After presintering in an oxygen atmosphere at 1550℃ for 5h followed by isostatical hot pressing at 1600℃ for 1h, the translucent alumina was highly dense, over 99.9% of the theoretical, and had 5 to 10㎛ size grains with a high hardness of 14.1GPa. The color was slightly dark due to the carbon atmosphere in the hot isostatic press, however, it would not affect the performance as yarn guides. Owing to the ultra high density, high hardness and fine microstructure, the isostatically hot pressed yarn guides would satisfy the requirements for the application in the high-speed textile machine.

담관계 감염증에서 혈액 및 담즙배양 균주의 특성과 항생제 감수성

송재훈,이철환,김양수,이성구,이근찬,민영일,김명환 대한감염학회 1994 감염 Vol.26 No.1

During a three-year period, 600 patients were admitted to the Asan Medical Center because of biliary tract diseases. Both aerobic and anaerobic cultures were performed in 313 patients with cholangitis (bile : 253, blood : 113, both : 53). Of these patients, 189 were positive(bile 159. blood 68. both 38). The most common organisms were E. coli, K pneumoniae, and P. aeruginosa in both bile(respectively, 49.7%, 20.8%, 51.5%) and blood cultures(respectively, 45.6%, 26.5%, 22.1%). Antibiotic therapy did not sterilize bile, but selectively increased the proportions of P. aeruginosa. There was no significant difference in biliary bacteriology according to the history of biliary surgery, or the presence of percutaneous biliary drainage or underlying disease. More than 95% of gram-negative organisms isolated was highly susceptible to imipenem and amikacin. P. aeruginosa was resistant to ceftazidime in 63.3% which might be associated with overuse of the drug during the study period. Further studies will be necessary in patients with cholangitis to determine whether newer antibiotics replace previous combination therapy.

부인과적 진단 복강경술에 대한 임상적 고찰

곽재환,박진완,황태영,김현호,이원기 동아대학교의과대학 1992 동아의대학술지 Vol.4 No.1

Silane 合成에 관한 硏究

梁在乾,韓貞璉,姜斗煥 단국대학교 1978 論文集 Vol.12 No.-

Methyl chloride was synthesized by using the continuous circulation reactor which developed in the Institute of Organo Silicone Compound (ofDAN Kook University), Especially, the experiment was carried out to increase the yield of dimethyl dichloro silane. Metalic silicon crushed to 100 mesh, copper powder <200∼200mech> as catalyst, and, Ni, pb, Mn, Zn, Ca, Al, as auxiliary were mixed, and the amount of catalyst was used 10∼20% in comparison to the metalic silicon. Methyl chloride preheated to 260℃ was supplied to the bottom of the reactor after dried. completely The temperature of the reaction was controlled to 300±10℃ and the pressure in the reactor was 1∼2atm. The yield of dimethyl dichloro silane was good, when the 1st conversion of methyl chloride was less than 58%, and the small amount of the group Ⅰ.Ⅱ. element as auxiliary catalyst was added. The yield of the dimethyl dichloro sllane experimented by the condition was 83%.

비접촉식 측정데이터를 이용한 근사 곡면 생성 및 영역화

김재현,박정환,고태조,유우식 嶺南大學校 工業技術硏究所 2001 工業技術硏究所論文集 Vol.29 No.2

As well known, the non-contact measuring method via the laser scanning or vision system provides vast amount of measuring points by which we rapidly identify the overall shape. On the other hand, its measuring accuracy (resolution) may be lower than that of touch probing method. From the reverse engineer's point of view, it is meaningful and efficient to fully utilize the merits of each methodology. This paper describes the construction of an overall approximate surface model by the non-contact measurement data (cloud-of-points), and the segmentation scheme for identifying sub-areas which should further be digitized by a scanning touch probe. The segmentation is performed through extracting the featured boundary edges or shapes (sharp edges or blend surfaces) by a pencil curve tracing algorithm.