• Journal of Chest Surgery
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• 제2권2호
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• pp.167-167
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• 1969

Two groups of esophagus graft were done in canine esophagus in 34 adult mongrel dogs. For the first group segmental replacement graft was done with fresh autologous pericardium tube, and for the second, patch graft was done utilizing fresh autologous pericardium, fresh homologous pericardium,and dacron piece. All eight dogs in the first segmental replacement graft group died 2 to 5 days after operation with severe empyema caused by anastomosis disruption. Among 26 patch graft dogs 2 died during operation and 7 died 13 to 18 days after operation. For the 17 long-term patch grafted survivors esophagography and postoperative weight check were done. Postoperative stool was collected and examined for dacron patch excretion. One, two, three, and four months postoperative long-term survivors were sacrificed to obtain specimens in each group respectively and the following observations were made.I. Survival; Autologous pericardium patch group showed no mortality but in homologous pericardium and dacron patch group only two thirds were long-term survivors. II. Postoperative swallowing; There was no case which demonstrated postoperative dysphagia. About half of the cases showed postoperative weight increase and in only 3 cases weight decrease followed operation. III. Dacron patch was excreted in the stool 8 to 23 days after operation. Animals which excreted dacron patch up to 9 days after operation all died of empyema due to anastomosis disruption.IV. Postoperative esophagogram; All esophagograms in each group showed no leakage of barium, no passage disturbances and no remarkable stenotic signs.V. Morphological findings; [A] Macroscopical findings; In one month group specimens of each group dense adhesion with surrounding structures was noted and luminal surface was smooth with contraction of the patched area. In two month groups anastomosis sutures were still exposed but patched area showed lesser abnormality. In three to four months groups sutures were covered completely and patched area showed only very slight signs of contraction. [B] Microscopic findings; In one month group luminal surface of the replaced tissue [transplanted tissue] showed almost complete epithelial covering that is composed of several layers of squamous cells with no evidence of keratinization. Basement membrane was also well distinct throughout. Slight to minimal inflammatory cells comprising of large mononuclears, lymphocytes and plasma cells were observed in the subepithelial fibrous stroma consisted entirely of loose fibrous tissue containing many newly formed capillaries and fibroblastic proliferation. Scattered suture granulomas were found, few of which became acutely inflamed. In two months group repairing process progressed with lesser degree of inflammatory cell infiltration and young capillary proliferation. Fibrous tissue was more matured showing even focal collagenization.Suture granuloma persisted but with lesser reactive changes. Epithelial covering was that of a mature non-keratinizing stratified squamous epithelium. In three and four months groups the replaced area showed essentially similar histological findings. However, subepithelial stroma still consisted entirely of connective tissue without evidence of smooth muscle regeneration. In this group, inflammatory cell infiltration was minimal or negligible. Among these patch materials autologous pericardium group showed the most satisfactory repairing process.The above mentioned results may signify the feasibility of autogenous pericardium patch graft in clinical esophageal surgery.

• Journal of Chest Surgery
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• 제2권2호
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• pp.168-186
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• 1969

Two groups of esophagus graft were done in canine esophagus in 34 adult mongrel dogs. For the first group segmental replacement graft was done with fresh autologous pericardium tube, and for the second, patch graft was done utilizing fresh autologous pericardium, fresh homologous pericardium,and dacron piece. All eight dogs in the first segmental replacement graft group died 2 to 5 days after operation with severe empyema caused by anastomosis disruption. Among 26 patch graft dogs 2 died during operation and 7 died 13 to 18 days after operation. For the 17 long-term patch grafted survivors esophagography and postoperative weight check were done. Postoperative stool was collected and examined for dacron patch excretion. One, two, three, and four months postoperative long-term survivors were sacrificed to obtain specimens in each group respectively and the following observations were made. I. Survival; Autologous pericardium patch group showed no mortality but in homologous pericardium and dacron patch group only two thirds were long-term survivors. II. Postoperative swallowing; There was no case which demonstrated postoperative dysphagia. About half of the cases showed postoperative weight increase and in only 3 cases weight decrease followed operation. III. Dacron patch was excreted in the stool 8 to 23 days after operation. Animals which excreted dacron patch up to 9 days after operation all died of empyema due to anastomosis disruption. IV. Postoperative esophagogram; All esophagograms in each group showed no leakage of barium, no passage disturbances and no remarkable stenotic signs. V. Morphological findings; [A] Macroscopical findings; In one month group specimens of each group dense adhesion with surrounding structures was noted and luminal surface was smooth with contraction of the patched area. In two month groups anastomosis sutures were still exposed but patched area showed lesser abnormality. In three to four months groups sutures were covered completely and patched area showed only very slight signs of contraction. [B] Microscopic findings; In one month group luminal surface of the replaced tissue [transplanted tissue] showed almost complete epithelial covering that is composed of several layers of squamous cells with no evidence of keratinization. Basement membrane was also well distinct throughout. Slight to minimal inflammatory cells comprising of large mononuclears, lymphocytes and plasma cells were observed in the subepithelial fibrous stroma consisted entirely of loose fibrous tissue containing many newly formed capillaries and fibroblastic proliferation. Scattered suture granulomas were found, few of which became acutely inflamed. In two months group repairing process progressed with lesser degree of inflammatory cell infiltration and young capillary proliferation. Fibrous tissue was more matured showing even focal collagenization. Suture granuloma persisted but with lesser reactive changes. Epithelial covering was that of a mature non-keratinizing stratified squamous epithelium. In three and four months groups the replaced area showed essentially similar histological findings. However, subepithelial stroma still consisted entirely of connective tissue without evidence of smooth muscle regeneration. In this group, inflammatory cell infiltration was minimal or negligible. Among these patch materials autologous pericardium group showed the most satisfactory repairing process. The above mentioned results may signify the feasibility of autogenous pericardium patch graft in clinical esophageal surgery.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.216-220
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• 2001

Objective : Cranioplasty is required to protect underlying brain, to correct major aesthetic deformities, or both. The ideal material for this purpose is autogenous bone. When this is not available, alloplastic or artificial materials may be used. In this study authors compared the infection rate according to the cranioplasty materials(the frozen autologous bone vs. bone cement), and duration of the skull defect. Materials : Between May 1994 and December 1999, 111 patients with skull defect treated with cranioplasty(82 cases of frozen autologous bone and 29 cases of artificial bone material) were included in this study. There were 77 males and 34 females with a mean age of 41.4 years(range 1-85 years). 57 patients had head trauma and 54 had non-traumatic insults. According to the duration of skull defect, there were 28 cases under 1 month, 33 cases of 1-2 months, 15 cases of 2-3 months, 20 cases of 3-6 months and 15 cases over 6 months of duration. Results : Overall infection rate was 9.9%. In cases with frozen autologous bone and artificial bone material, the infection rate was 8.5% and 13.7%, respectively. The infection rate according to the duration of skull defect was 3.6%(among 28 cases) under 1 month of age, while those were 12%(4 among 33 cases) at 1-2 months, 20%(3 among 15 cases) at 2-3 months, 5%(1 among 20 cases) at 3-6 months and 13%(2 among 15 cases) over 6 months. Accoring to the underlying disease, the infection rate in traumatic cases was 12%(7 among 57 cases) and that in non-traumatic one was 3.7%(2 among 54 cases). Conclusion : From this study, it appears that skull defect should be repaired as soon as possible, because early cranioplasty can lower the infection rate. And surgeons could save the patients' cranial bone as possible as they can because autologous bone is not only cost effective in cosmatic purpose but lower the infection rate.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.507-513
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• 2000

Objective : Posterior lumbar interbody fusion(PLIF) with transpedicular screw fixation(TPSF) have many merits in the treatment of spondylolisthesis. The aim of this study was to compare cage PLIF group(PLIF using cage and TPSF) with chip PLIF group(PLIF using autologous bone chips and TPSF) as surgical treatment of spondyloisthesis. Methods : PLIF and TPSF were performed in 44 patients with spondylolisthesis from January 1994 to December 1998. The surgical methods were divided into two groups. One group was cage PLIF(20 patients), and the other group was chip PLIF(24 patients). We analyzed the change of anterior translation, change of intervertebral space height, fusion rate, clinical outcomes, and postoperative complications in two groups. Result : There was no significant difference in reduction and maintenance of anterior translation between two groups. Intervertebral space height was increased in the two groups at immediate postoperative state. At last followup, it was decreased compared to preoperative height in chip PLIF group. In cage PLIF group, last follow-up height was decreased compared to immedate postoperative height, but it was significantly increased compared to preoperative height. Fusion rates were 70.9% and 90% in chip PLIF group and cage PLIF group, respectively. Excellent and good clinical outcomes were 79.2% in chip PLIF group and 85% in cage PLIF group, but there was no statistical significance. Complications were screw fracture(1 case), CSF leakage(1 case) in chip PLIF group and screw loosening and retropulsion of cage(1 case), CSF leakage(2 cases) in cage PLIF group. Conclusion : PLIF using cage is better than PLIF using autologous bone chips in the maintenance of intervertebral space height and fusion rate. But there is no statistical difference of the clinical outcomes between the two groups. Further studies, especially on long term follow-up, should be considered.

• 한국융합학회논문지
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• 제12권3호
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• pp.27-34
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• 2021

본 연구는 COVID-19 (coronavirus disease 19) 우울 정도가 삶의 질에 영향을 주는 요인에서 구강건강행위와 자가구강건강증상이 미치는 영향을 확인하기 위한 기초자료로 제공하고자 한다. 본 연구는 2020년 7월부터 2020년 9월까지 자료를 수집하였고, COVID-19로 인한 우울비증가 그룹 89명, 우울증가그룹 86명을 대상으로 최종 분석하였다. 분석방법으로 구강건강행위와 자가구강건강증상, 삶의 질을 비교하였고, 우울정도가 삶의 질에 미치는 영향에서 구강건강행위와 자가구강건강증상이 미치는 영향을 확인하기 위해 위계적 회귀분석(Hierarchical regression analysis)을 시행하였다. 그 결과 인구학적 특성을 통제하고, 삶의 질에 미치는 영향을 확인한 결과 구강건강행위를 제외한 우울정도(��=-0.155, p=0.012)와 자가구강건강증상(��=0.524, p<0.001)은 유의한 영향이 있었다. 따라서 COVID-19로 우울과 불안을 해소하기 위한 지역사회의 정신건강과 관련된 프로그램 개발이 시급하며, 치과치료를 적절한 시기에 받을 수 있도록 치과방문에 대한 불안감을 해소시키기 위한 홍보 활동이 필요할 것이다.

• Tuberculosis and Respiratory Diseases
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• 제49권6호
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• pp.724-732
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• 2000

연구배경 : 심한 폐기능 장애가 만생 폐질환 환자에서 발생한 기흉은 그 정도가 심하지 않더라도 심한 호흡곤란을 일으켜 환자의 생명을 위협하기도 한다. 우선 공기 천자 및 흉관삽입을 시행한 후에도 공기누출이 지속되는 경우 흉강경을 이용한 수술적 치료로 공가누출을 근원적으로 막는 것이 가장 좋은 방법이다. 그러나 심한 폐 손상으로 흉강경 삽입을 할 수 없는 경우에는 삽입된 흉관을 통하여 흉막유착을 시도하게 된다. 흔히 사용되는 제재는 tetracycline, talc powder, silver nitrate 등이며 때로는 OK-432, 항암제인 bleomycin, mitomycin등이 사용되기도 한다. 한가지 방법으로는 실패한 경우 다른 약제로 재시도 하지만 그래도 공기누출이 지속되는 경우에는 입원기간이 장기화 되면서 경제적 손실이 따르고 호흡기 합병증이 발생가능하며 때로는 사망할 수도 있다. 또한 주로 사용되던 주사용 tetracycline과 doxycycline 마저 최근 국내 생산이 중단되어 새로운 흉막유착물로의 대체가 필요한 실정이다. 한편 외상등으로 발생한 혈흉에서 적절히 배액되지 않으면 섬유흉(fibrothorax)이 발생 하며, 심한 경우 외과적 흉막박피술로 이를 제거하여야 할 정도로 혈관 밖으로 나온 혈액은 흉강내에서는 강력한 자극제로서 조직간에 유착을 일으킨다는 사실이 이미 알려져 있어 이를 이용한 자가혈액 흉막유착술의 유용성을 알아보고자 하였다. 방법 : 공기누출이 지속되는 기흉이 합병된 중증 만성 폐질환 환자에서 자가혈액 흉막유착을 시행하였다. 이들은 수술적 치료에 적응증이 되지 않았고 일차적으로 시행한 doxycycline 흉막유착술에 실패한 예이다. 흉관 삽입 후 폐가 충분히 펴진 다음에 정맥에서 채취한 환자의 혈액과 50% dextrose를 같은 비율로 섞은 용액을 흉관 또는 pig-tail 카테터를 통하여 흉강대로 주입하여 흉막유착술을 수회 시행하였다. 이의 효과와 통증의 정도, 합병증 여부를 확인하였고, 기흉 발생 이전과 흉막유착후의 호흡곤란 정도와 폐기능의 변화에 대하여 조사하였다. 결과 : 자가혈액 흉막유착술은 지속적인 공기누출이 있는 기흉을 가진 대부분의 대상환자에서 성공적이었으며 1예에서만 6개월 뒤 재발하였다. 자가혈액 흉막유착술 이전의 공기누출기간은 평균 18.4일 이었고 이후는 5.2일 이었다. 일차로 시행한 doxycycline 흉막유착술에 비하여 통증이 적었으며 시술중 4예에서 미열이 있었고 이외의 다른 합병증은 없었다. 평균 21개월(2~68개월)간 추적검사 하였는데 흉막유착은 8예에서 경도로 있었다. 기흉발생 이전과 흉막유착술 시행 후의 호흡곤란 정도와 폐기능 변화는 없었다. 결론 : 자가혈액은 흉막유착술에 이용될 수 있는 유용한 제재로 생각된다. 지속척인 공기유출이 있는 기흉에서 쉽고 적은 비용으로 효과적으로 사용될 수 있었고 시술중이나 시술후에 큰 합병증도 발견되지 않았으며 무엇 보다도 혈액은 얻기가 쉽다. 기존의 doxycycline을 이용한 흉막유착술에 비하여 환자가 통증을 적게 호소하여 편안할 뿐만 아니라 tetracycline계의 약물과 달리 혈액은 때로는 patch로 작용하여 공기누출을 막는 효과가 더 높으며 추적 관찰 결과 시술후의 늑막유착은 심하지 않았다. 따라서 중증 만성 폐질환 환자에서 지속적인 공기누출이 있는 기흉이 있고 수술적 치료에 의한 적용이 되지 않는 경우 자가혈액을 이용한 흉막유착술은 유용한 치료법이라고 사료된다.

• Communications for Statistical Applications and Methods
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• 제5권2호
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• pp.447-458
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• 1998

본 논문에서는 환자의 수명과 치료횟수의 모형화를 위해 관측가능한 공변량을 포함하는 동시에 두 변수에 영향을 미치는 관측불가능한 환경요인을 고려하기 위한 개별환경효과모형을 도입하고자 한다. 개별환경효과를 나타내는 분포를 감마분포로 가정하여 사망시간과 치료횟수의 모형을 개발하고, 모형에 포함된 모수의 추론과정을 논의하며, 개발된 모형을 Autologous Blood and Marrow Transplant Registry(ABMTR)에 등록된 환자의 자료에 적용하여 환경효과를 고려하지 않은 독립모형과 비교하고자 한다.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2012년도 추계학술대회 논문집
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• pp.883-884
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• 2012

• 대한치과보철학회:학술대회논문집
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• 대한치과보철학회 2001년도 추계학술대회
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• pp.71-71
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• 2001

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 제21차 추계 학술대회
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• pp.122-123
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• 2009