• Title/Summary/Keyword: 확장술

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Surgical Experience of Aortic Root Replacement (대동맥근부치환술의 임상경험)

  • Kim, Hyun-jo;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1197-1204
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    • 1997
  • Between April 1981 and June 1996, 65 patients had aortic root replacement at our institution. Disease entities were pure aortic annuloectasia in 31 patients(47.7%), Stanford type A aortic dissection with annuloectasia in 8(43.1%), atherosclerotic aneurysm with aortic regurgitation in 4(6.2%), and paravalvular leakage after aortic valve replacement in 2(3.1 %). 34 patients(52.3%) had the clinical stigmata of the Marfan syndrome. The operative procedures were Bentall operation in 61 patients(93.8%); 3 of conventional procedure and 58 of Cabrol's modification, aortic valve-sparing operation in 2(3.1 %), and root replacement with homograft in 2(3.1%). Hospital deaths occurred in 3 patients(4.8%) because of uncontrolled bleeding(1) and bypass weaning failure due to low cardiac output(2), and all had emergency operation with Cabrol's procedure. Postoperative complications developed in 19(29.2%) patients and most of them were transient. Surviving 62 patients have been followed up to cumulative total 315.0 patient-years(mean 60.2 $\pm$42.4 months). Late deaths occurred in 7 patients(11.3%), aneurysmal changes of remaining aorta were detected in 12 patients(19.4%). Actuarial survival rate at 10 years was 72.0 $\pm$ 9.7%, and the subsequent aortic operation-free rate at 10 years was 68.0$\pm$ 8.9% In a multivariate analysis, Marfan syndrome, emergency operation, preoperative dissection, combined arch replacement, and total circulatory arrest emerged as significant risk factors for hospital death or subsequent aortic operation. Over 60 years of age was the only risk factor for late death. Our 16 years'cummulative experience shows that aortic root replacement, mainly by means of Cabrol's procedure, can be applied successfully to variety of aortic root disease. However, long-term follow up will be needed to determine the late result of aortic valve-saving operation and root replacement with homograft. When dissection is present or the distal native aorta is diseased in'Marfan patients, close follow-up is necessary because of the subsequent aneurysmal change of remaining aorta.

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A Study of the Wanpan-changgeuk(完板唱劇) directed by Hur Gyu : Focusing on Changgeuk Dramaturgy (허규 연출 완판창극의 창극술 연구 - <흥보전>(1982)과 <흥보가>(1984)를 중심으로 -)

  • Kim, Hyang
    • (The) Research of the performance art and culture
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    • no.34
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    • pp.73-109
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    • 2017
  • This article studies Hur Gyu's Wanpan-Changgeuk Heungbojeon (1982) and Heungboga (1984), with a specific focus on the dramaturgy of Changgeuk and its meaning as transformed from Pansori Heungboga. The dramaturgy of Wanpan-Changgeuk Heungbojeon and Heungboga served to express criticism toward selling oneself. Beyond their former classical theme of brotherly affection, these productions elicited sorrow at the sight of poverty through a dramaturgy integrating modern theatricality with the Korean dramatic style. The theme of grief for poverty in these Changgeuk plays simultaneously aroused spectators' sympathy and critical thinking about economic aspects. Moreover, the Korean drama style and humor were not used simply as a tool but to exhilarate an emotional response to a life of coexistence. This paper found that Hur Gyu's Wanpan-Changgeuk Heungbojeon and Heungboga recreated a new Changgeuk dramaturgy based on the director's integration of western thinking and Korean traditional culture on stage. Through this, Hur Gyu tried to expand spectators' sympathy and to achieve artistic and popular success. Thus, these value of Hur Gyu's Wanpan-Changgeuk lay not only in its long running-time, but in its dramaturgy of integrating thinking for his Minjokgeuk (nationalist theater).

Comparison Between HRCT abd Bronchography for Bronchiectasis (기관지 확장증에서 고해상도 전산화 단층 촬영술과 기관지 조영술의 비교)

  • 김승규
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.871-873
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    • 1993
  • Bronchiectasis is an irreversible dilatation that may require surgery for successful treatment. We compared High Resolutional Computed Tomography[HRCT]with Bronchography to access the utility of HRCT in diagnosis and determining the extent of Bronchiectasis. We performed a comparative study of HRCT and Bronchography in 10 consecutive patients who were clinically suspected Bronchiectasis were investigated prospectively during last year.A segment-by-segment analysis of the presence, extent, type of bronchiectasis by Amashita classification was done. In 26 segments, Results of HRCT and Bronchogram were both positve, and 119 segments were both negative.But 15 segments were discorded, in 11 segments in positive bronchogram were negative in HRCT and 4 segments in positive HRCT were negative in bronchogram. The diagnostic concordance rate between 2 modalities was 90.6%[145/160]. So, we will be tried to elevate of concordance rate between 2 modalties and applied HRCT in diagnotic tool for bronchiectasis.

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The Compression of Left Main Bronchus Caused by Dilated Descending Aorta After Ligation of PDA (동맥관 개존증 결찰 후 확장된 하행대동맥에 의한 좌측 주기관지 협착)

  • 강정한;박영환;윤영남;김부연;김시호;홍유선;조범구
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.974-977
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    • 2000
  • 유아에서 흔치 않지만, 선천적 혹은 후천적 원인으로 혈관에 의해 기도가 눌릴 수 있다. 8개월 남자 환아가 승모판 성형술, 동맥관 개존증 결찰 후 좌측 폐의 무기폐가 발생하였다. 흉부 컴퓨터 단층 촬영상 동맥관 개존증 결찰 후 남은 비대해진 하행대동맥에 의해 좌측 폐의 무기폐가 발생하였다. 흉부 컴퓨터 단층 촬영상 동맥관 개존증 결찰 후 남은 비대해진 하행대동맥에 의해 좌측 주기관지가 눌리는 소견이 관찰되었다. 결찰 부위를 완전히 분리하고 하행대동맥을 봉합하여 크기를 줄여 기관지 압박을 해결할 수 있었다. 술 후 환자는 특별한 합병증 없이 퇴원하였으며 외래 추적 관찰 중이다.

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Application of Technology Replication and Film Works - Focused on the Concept of Walter Benjamin - (기술 복제의 응용과 영화 작품 - 발터 벤야민의 개념을 중심으로 -)

  • Chen, Yi Wen;Choi, Won-Ho
    • Proceedings of the Korea Contents Association Conference
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    • 2019.05a
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    • pp.241-242
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    • 2019
  • 발터 벤야민은 그의 저서인 '기계복제시대의 예술작품'에서 영화를 인쇄술, 사진술과 같은 기계복제의 예술품으로 묘사하였다. 분명 영화는 복제에 기반을 둔 예술이다. 나아가 21세기에는 컴퓨터 기술이 향상과 함께 컴퓨터그래픽에 대한 의존도는 더욱 높아졌다. 이러한 경향은 영화를 제7의 예술로 추동하는 '놀랄 만한' 효과와 그 영향을 약화시켰다. 바로 벤야민이 기계복제로 인해 우려했던 지점이기도 하다. 하지만 기술의 향성은 부정적 우려와 함께 영화제작의 효율성을 제고하고 있는 것도 사실이다. 이에 연구자는 기계복제에서 나아가 디지털까지 확장된 영화에 대해 연구하고자 한다.

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Limb Salvage Surgery after Removal of Infected Tumor Prosthesis with Equalization of Leg Length (감염된 종양 대치물 제거와 하지 단축 보정 후 시행한 사지 구제술 - 증례 보고 -)

  • Kwon, Young-Ho;Kim, Jae-Do;Chung, So-Hak;Cho, Yool
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.141-147
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    • 2006
  • In 1996, a nine-year-old girl was treated with recycling autograft after wide resection of the distal femoral osteosarcoma. The leg lengthening and revision with growing tumor prosthesis were performed due to limb leg discrepancy and epiphyseal problem. However, deep infection developed after operation, and a temporary spacer with cement and Ender nail was inserted. After infection was controlled completely, the final leg lengthening was performed with mono-external fixator for limb length discrepancy (10 cm). Lastly, Tumor prosthesis was reinserted to preserve the joint function.

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Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass (정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예)

  • Park Han Gyu;Choi Chang Woo;Lee Jae Wook;Her Keun;Shin Hwa Kyun;Won Yong Soon
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.72-75
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    • 2006
  • In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).

Regression of Left Ventricular Mass after Aortic Valve Replacement in Isolated Aortic Regurgitation (단독 대동맥판막 폐쇄부전 환자에서 대동맥판막 치환술 후 좌심실 질량의 변화)

  • Jung, Tae-Eun;Lee, Dong-Hyup;Lee, Seok-Soo
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.614-618
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    • 2010
  • Background: The aim of our study was to assess the extent of regression of left ventricular mass after aortic valve replacement in isolated aortic regurgitation. Material and Method: Retrospective analysis of echocardiographic data was collected preoperative and postoperative 1 year. There were 20 patients (12 males, 8 females, mean age $55.8{\pm}11.8$ years, mean body surface area $1.64{\pm}0.19m^2$) with aortic regurgitation from 2002 through 2007. We studied the change of left ventricular ejection fraction, ventricular septum and left ventricular posterior wall thickness, and left vemtricular muscle index (LVMI). The control group was age matched with normal echocardiographic study results. Patients with combined surgery or infective endocarditis were excluded. Result: Seven cases of tissue valves and thirteen cases of mechanical valve were used. The valve sizes were 21 mm (3 cases), 23 mm (13 cases) and 25 mm (4 cases). The postoperative ($125.5{\pm}42g/m^2$) LVMI has decreased than preoperative LVMI ($212.3{\pm}80g/m^2$, p=0.000) but higher than that of control group ($80.5{\pm}15.9g/m^2$, p=0.000). Postoperative septal wall (systolic/diastolic: $13.5{\pm}3.4mm/17.1{\pm}4.1mm$) and left ventricular posterior wall (systolic/diastolic: $12.9{\pm}3.4mm/16.7{\pm}3.4mm$) thickness were slightly decreased after the valve replacement but was not significantly different than preoperative levels. And postoperative interventricular septal wall and left ventricular posterior wall thickness (systolic/diastolic: $8.6{\pm}1.4mm/12.1{\pm}1.7mm$, systolic/diastolic: $8.4{\pm}1.4mm/13.2{\pm}1.9mm$) were higher than that of the control group (p<0.001). Conclusion: The significant regression of LVMI after aortic valve replacement developed at postoperative one year but the level was higher than control group. The main cause of decreased LVMI is decreased in left ventricular dimension.

A Study on Actor's Dramatics Expansion using Practical use of Media in Performing Arts (공연예술에 있어 영상 활용을 통한 배우의 연기술 확장에 관한 연구)

  • Eo, Il-Sun;Han, Jung-Soo;Jin, Won-Sung
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.1
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    • pp.89-98
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    • 2019
  • Performing arts, for instance, theatre and dance that perform on the stage, should recognize the contemporary characters and also emphasize the trend of the times. Thus, the subject of those varies and provides the audience diversity contents and style. People who perform those try to put the contemporary characteristic and sociality into their stage by utilizing new technology for their stage to be more sophisticated in aesthetic and philosophic aspects. According to the trend of the times, science and technology have been making great progress. As a result, the stage technology continues to develop, contributing to enhance the aesthetic and philosophical completeness of the performing arts. Also, there are technical and formal researches or methods constantly that make the performing arts new and diverse. Therefore, it can be said that it is very important to widen a category of the performing arts that amplify the actor's acting and emotions on the stage and then give the audience an experience. This paper will analyze in the way which various image techniques utilize to widen the actor's technique in the performing arts and the actor's technique progresses in the era called the Fourth Industrial Revolution era that grafts the art onto new media. Through this paper, in the era of the Fourth Industrial Revolution, a new paradigm in actor's acting which is becoming a hot topic in performing arts is predicted and anticipated.

Analysis of Risk Factors in Coronary Artery Bypass Surgery (관동맥우회술의 위험인자 분석)

  • 정태은;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1049-1055
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    • 1998
  • Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

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