• Journal of Chest Surgery
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• v.33 no.12
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• pp.971-973
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• 2000

원발성 심장 림프종은 드문 질환으로 원발성 심장종양의 1.3%를 차지하며 절외성 림프종의 0.5%에서 발생한다. 그러나 악성 림프종에 의한 이차성 심장 전이는 비교적 빈번해서 약 8.7-27.2%로 보고 되고 있다. 66세남자 환자는 호흡곤란을 주소로 내원하였다. 경흉부 심초음파에서 우심방내에 종괴가 관찰되었다. 종양의 수술적 제거를 시행하였고 조직학적 검사에서 우심방을 침범한 악성 임파종으로 진단되었다. 환자는 급성 종격동염이 발생하였고 술후 9일째 패혈증과 수술부위 출혈로 사망하였다.

• Journal of Korea Multimedia Society
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• v.11 no.9
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• pp.1267-1276
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• 2008

The time taken for an ischemic heart disease patient to have a percutaneous coronary intervention because of acute myocardial infarction after arriving at the hospitals (door-to-balloon time) affects the patient's mortality significantly. To improve the emergency service system that has been previously used in the hospitals, this study focused on reducing door-data time and data-to-decision time among three time stages. The newly established e-emergency service system has set up the database of patients that had an emergency operation for acute myocardial infarction in the emergency service system of the hospital and has issued health cards for the patients that regularly visit the Busan National University Hospital. In addition, it has stored prior operation permits in the form of a certified electronic document. The new electronic system will reduce the complex treatment and operation procedures innovatively. Therefore, it is expected that this will make the life save (or the emergency patients easier and reduce the mortality. Moreover, it will also settle down the hospital staff's and patients' predicaments caused by the complex procedure of the legacy system.

• Journal of Preventive Medicine and Public Health
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• v.34 no.2
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• pp.109-118
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• 2001

The purpose of this review is to discuss the debate concerning the interpretation of epidemiologic studies on particles and health effects. Study of the 1952 air pollution disaster in London established that very high levels of particulate-based smog can cause dramatic increases in daily mortality. However, recent epidemiologic studies have reported statistically significant health effects and mortality due to low levels of air pollution. The statistical significance does not prove causation in observational studies; therefore it is necessary to evaluate these associations. There are arguments for and against each of the numerous studies using Hill's criteria, however the body of accepted evidence supports the causal association. In particular, a high level of consistency in the estimated effect of PM10 has been observed across studies worldwide. The mechanism of the relationship between air pollution and health effects is not obvious. The mechanism of particle-induced injury may involve the production of an inflammatory response by the particulate. The harvesting and the threshold effect are also major concerns regarding the health effects of air pollution. However, current epidemiologic findings indicate that linear models lacking a threshold are appropriate for assessing the effect of particulate air pollution on daily mortality even at current levels.

• Journal of Digestive Cancer Research
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• v.5 no.1
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• pp.62-65
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• 2017

Pancreatic cancer is an aggressive disease and despite the efforts of the past few decades, the 5-year overall survival (OS) rate remains disappointing and does not exceed 10% in Korea. Especially, only 15-20% of patients are candidates for surgical resection because most patients are diagnosed with locally advanced or metastatic disease, and their only treatment approach is palliative chemotherapy. Since the first chemo-regimen of Gemcitabine and Nanoparticle albumin bound (nab) - paclitaxel was brought to clinical practice in 2013, the improvement in overall survival, progression-free survival, and response rate was achieved in patients with metastatic pancreatic adenocarcinoma. We report the case of a young patient with cardiogenic shock accompanied by multi-organ failure after 4^th cycle Gemcitabine and nab-paclitaxel chemotherapy with partial response.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.358-363
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• 1999

Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2009.05a
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• pp.108-108
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• 2009

일본에서는 일차보건의료의 중요성을 강조하고 건강증진 향상을 위한 노력의 일환으로 제기된 알마아타선언이 발표된 1978년과 때를 같이 하여 같은 해부터 국민건강 만들기 대책이 시작되어 지금까지 30여년의 시간이 지났다. 그 동안 두 차례의 정책수정 과정을 거쳐, 2000년부터는 제3차 건강만들기의 활동으로 "건강일본 21"을 실시하고 있다. 건강일본 21의 기본적인 목적은 모든 국민이 건강하고, 활기가 넘치는 사회를 실현하며, 조기사망을 예방하고 치매와 같은 병상상태의 생활에서 벗어나 건강수명을 연장하는 것으로 하고 있다. 이를 위하여 조기사망이나 장애와 관련된 암, 뇌졸중, 심장질환, 자살 등과 같은 질환군을 파악하고, 이러한 질환군에 영향을 미치는 비만, 고혈압, 당뇨, 치주질환 등에 관한 위험군을 찾아내어, 이러한 것들을 사전에 예방할 수 있도록 하는 흡연, 음주, 식사, 운동과 같은 생활습관과 관련된 요인들을 개선하도록 하는 노력을 기울이고 있다. 이에 본 연구에서는 건강일본 21에서 사업영역으로 정한 (1) 영양 및 식생활, (2) 신체활동 및 운동, (3) 휴양 및 마음의 건강 만들기, (4) 흡연, (5) 음주, (6) 치아건강, (7) 당뇨병, (8) 순환기질환, (9) 암 등에 관한 각 분야에 있어서 현재의 현황을 알아보고, 지금까지의 성과를 파악하며 앞으로의 현실가능성을 전망해 보았다.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.242-246
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• 1998

From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

• 월간산업보건
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• s.292
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• pp.11-15
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• 2012

페놀의 작업 노출에 대한 TLV-TWA는 5ppm ($19mg/m^3$)으로 눈과 호흡기계의 자극과 함께 심장, 간, 신경 독성 영향을 최소화하기 위해 설정되었다. 페놀은 증기상과 액상 또는 고체상 형태로 피부에 접촉되면 흡수되어 심각한 계통 영향을 유발하여 최종적으로 사망에 이르게 한다. 피부를 통한 흡수율은 흡입에 의한 체내 흡수율과 거의 동일한 수준이다. 따라서 현재 Skin notation(피부흡수 경고) 물질로 지정되어 있다. 발암성 여부를 결정하기 위한 동물 실험 결과에서는 음성 또는 발암성을 판정하기에는 데이터가 부족한 관계로 A4로 지정되어 있다. 또한 SEN과 TLV-STEL도 유용한 자료의 부족으로 아직 설정되지 않고 있다. 페놀은 BEIs로 활용될 수 있는 기질 중 하나이다.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.769-774
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• 2001

Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.584-589
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• 2002

Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.