• Journal of Chest Surgery
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• 제35권11호
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• pp.779-784
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• 2002

최근 들어 관상동맥 질환자의 수가 급격히 증가하면서 관상동맥 우회술의 수도 급격히 증가하고 있다. 그러나 관상동맥 우회술은 영구적인 완전 교정술이 아니기 때문에 재수술이 필요할 수 있다. 저자들은 관상 동맥우회 재수술의 임상결과를 후향적 방법으로 고찰하여 보았다. 대상 및 방법: 1991년 1월부터 2001년 4월까지 연세 심장혈관 병원에서 관상동맥우회 재수술을 시행 받은 14명을 대상으로 하였으며 (남자:12명, 여자:2명), 평균 연령은 61.7$\pm$7.1(47~72세) 세였다. 처음 수술 받은 날부터 재수술시까지의 평균 기간은 121.9$\pm$50.5(6.1~179.6 개월) 개월이었다. 재수술시 13명의 환자들은 일반적인 심폐체외순환하에 수술을 하였고 1명의 환자는 심폐체외순환 없이 수술을 시행하였다. 동반 수술로는 1명의 환자에서 승모판막 재치환술을 시행하였고, 1명의 환자에서는 승모판막륜 성형술을 시행하였다. 재수술은 모두 정중 흉골절개하에 시행하였다. 재수술시 사용한 이식 혈관은 좌측 내흉동맥과 대 복재정맥을 사용한 경우가 6례, 좌측 내흉동맥과 좌측 요골 동맥을 사용한 경우가 2례, 좌측 내흉 동맥과 위장관 동맥을 사용한 경우가 1례, 대 복재정맥만을 사용한 경우가 5례(1례는 cephalic vein도 같이 사용) 있었으며, 평균 이식 편수는 2.1$\pm$0.9(1~4개) 개였다. 결과: 14명의 환자들 중에서 수술과 관련한 사망이나 조기 사망은 없었으며, 합병증은 신부전증, 호흡부전 및 경막하 출혈이 각각 1례 있었다. 평균 추적 관찰 기간은 40.1$\pm$38.6(1.1~l18.5) 개월 이었다. 추적기간 중 1명의 환자가 재수술 후 13개월에 협심증이 재발했고, 2명의 환자가 재수술 후 14.8개월 및 116.3개월에 만성 신부전증으로 사망하였다. 추적 기간 중에 3명의 환자에서 관상동맥 조영술을 시행하였는데 이식 혈관들은 모두 개존성을 보였다. 마지막 외래 내원시 생존 환자들의 평균 Canadian class는 1.3이었고, 재수술 후 9년까지 사건(event)이 없을 확률은 71.4$\pm$6.9%였으며, 생존률은 90.0$\pm$9.5%였다. 결론: 관상동맥우회 재수술은 수술 후에 환자 상태의 호전을 기대할 수 있고, 장기간의 생존률도 우수하기에, 수술적응이 된다면 수술을 적극적으로 고려하여야 할 것으로 생각한다.

• Journal of Chest Surgery
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• 제47권2호
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• pp.117-123
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• 2014

Background: Implanted venous access devices or permanent central venous access systems (PCVASs) are routinely used in oncologic patients. Complications can occur during the implantation or use of such devices. We describe such complications of the PCVAS and their management. Methods: Our retrospective study included 1,460 cases in which PCVAS was implanted in the 11 years between January 2002 and January 2013, including 810 women and 650 men with an average age of 45.2 years. We used polyurethane or silicone catheters. The site of insertion and the surgical or percutaneous procedure were selected on the basis of clinical data and disease information. The subclavian and cephalic veins were our most common sites of insertion. Results: About 1,100 cases (75%) underwent surgery by training surgeons and 360 patients by expert surgeons. Perioperative incidents occurred in 33% and 12% of these patients, respectively. Incidents (28%) included technical difficulties (n=64), a subcutaneous hematoma (n=37), pneumothoraces (n=15), and an intrapleural catheter (n=1). Complications in the short and medium term were present in 14.2% of the cases. Distortion and rupture of the catheter (n=5) were noted in the costoclavicular area (pinch-off syndrome). There were 5 cases of catheter migration into the jugular vein (n=1), superior vena cava (n=1), and heart cavities (n=3). No patient died of PCVAS insertion or complication. Conclusion: PCVAS complications should be diagnosed early and treated with probable removal of this material for preventing any life-threatening outcome associated with complicated PVCAS.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.152-157
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• 2018

Background Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment. Methods ICG fluorescence lymphography was performed by injecting 1 mL of ICG into the second web space of the hand. After 4 hours, fluorescence images of lymphatic vessels were obtained with a near-infrared camera, and the lymphatic vessels were marked. Three landmarks were designated: the radial styloid process, the mid-portion of the cubital fossa, and the lower border of the deltopectoral groove. A straight line connecting the points was drawn, and the distance between the connected lines and the marked lymphatic vessels was measured at 8 points. Results There were 30 healthy upper extremities (15 right and 15 left). The average course of the main lymph vessels passed $26.0{\pm}11.6mm$ dorsal to the styloid process, $5.7{\pm}40.7mm$ medial to the mid-cubital fossa, and $31.3{\pm}26.1mm$ medial to the three-quarters point of the upper landmark line. Conclusions The main functioning lymphatic vessel follows the course of the cephalic vein at the forearm level, crosses the mid-cubital point, and travels medially toward the mid-axilla.

• 대한수의학회지
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• 제29권3호
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• pp.253-262
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• 1989

This study was performed to investigate the patterns of progesterone secretion after induction of estrus in premature, metestrous and anestrous bitches. A total of 22 bitches were used. Of them 18 bitches were treated with hormone to induced estrus and 4 bitches were untreated and served as controls. Estrus was induced with $PGF_{2{\alpha}}$, estrone, estradiol-$17{\beta}$, PMSG and HCG(Treatment A), and with PMSG and HCG(Treatment B). Blood samples were collected via the cephalic vein at 2 to 5 days interval. Blood samples were centrifuged (1,200g, 10min.) within 30 minutes after collection and plasma was stored at $-20^{\circ}C$ until analyzed for the progesterone concentrations. Plamsa progesterone concentrations were measured by radioimmunoassay. The results of estrous induction were determined by estrous signs, ovarian response, egg recovery and progesterone patterns. The results obtained were as follows; 1. All bitches in treatment A showed estrous signs, however the ovarian response and egg recovery were not detectable and the levels of progesterone were nearly same as before. 2. In the treatment B, premature and metestrous bitches showed only estrous signs, however 5 of 7 anestrous bitches (71.4%) showed estrous signs, ovarian response and changes of progesterone levels. In conclusion, clinical estrous behavior can be induced during any phase of the estrous cycle, but ovulation should be induced only if induction occur approximately 4 months or more after the previous estrus.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1996년도 춘계학술대회
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• pp.220-220
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• 1996

The objectives of this study were to evaluate the pharmacokinetics of SJ-151 which is a new NSAID in male Beagle dogs following a single oral dosing. Seven beagle dogs (10-l2kg) were all administered a single oral gavage(10mg/kg) of SJ-151 tablet and serial blood samples of approximately 5$m\ell$ were then drawn from the cephalic vein of each animal at 0(predose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24hours postdosc. SJ-151 (Cinmetacinㆍbutendiol)and cimetacin were quantified in the plasma fraction by HPLC assay. The pharmacokinetic parameters calculated from the plasma concentrations of SJ-151 in dayl are Cmax(ng/$m\ell$)509$\pm$248, Tmax(hr) 1.50$\pm$0.45, AUC(ng.hr/$m\ell$) 1,750$\pm$762, tl/2$\alpha$ 0.98$\pm$0.30, t1/2$\beta$ 12.0$\pm$6.75. The pharmacokinetic parameters calculated from the plasma concentrations of Cinmetacin in day 1 are Cmax(ng/$m\ell$)258$\pm$74.1, Tmax(hr)2.42$\pm$ 0.92, AUC(ng.hr/$m\ell$) 1,820$\pm$318, t1/2$\alpha$ 1.74$\pm$0.49, t1/2$\beta$ 25.4$\pm$13.4.

• 한국임상수의학회지
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• 제6권1호
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• pp.185-191
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• 1989

A dog which was hospitalized to Veterinary Teaching Hospital, College of Veterinary Medicine, Jeonbug National University on December 28, 1988 was revealed severe anemia: hemoglobinuria and weakness. In the inspections, abdominal pain and spleno megaly at the ventral abdomen were detected by palpations. In the examinations of blood, the obtained results were summarized as follows: Babesla spp. was identified on the blood smear stained with Giemsa. The Babesia spp. was assumed to the Babesia gibsoni for the their small size and pleomorphism such as comma form, ring form and dot form. In the blood examinations of the patient, Ht: 22.5％, RBC:354${\times}$10$^4$/${\mu}\ell$, Hb: 8.8g/dl, serum protein: 8g/dl, and WBC count was 21, 425/${\mu}\ell$. In the chemical examinations of serum, the value of AST(GOT) was 30iu and ALT(GPT) was 20iu, respectively. The blood sugar was 60mg/d1. In the urine test, urine protein was 30mg/d1 and the hemoglobin In the urine was the ＋＋＋ and occult blood reaction(Benzidine test) in the feces was ＋＋＋. Splenomegaly was confirmed by X-ray examination. To confirm for the Babesia spp. infection, 5ml of the whole blood of the patient(3％ of Parasitized erythrocytes) were inoculated into the cephalic vein of the two normal dogs. In the blood of experimental dogs which were inoculated parasitized blood, Babesia spp. was detected in the two doss and pleomorphic parasites were observed, too. In the blood examinations of No. 1 the Ht and RBC were decreased to 6.8％ and 52${\times}$10$^4$/${\mu}\ell$, respectively. WBC count was 10.600/${\mu}\ell$ and serum protein was 6.8g/dl. The rates of parasitized erythrocytes were 15％ in the experimental dog. Also ＋＋＋ of the hemoglobin was detected in the urine. In the X-ray examination, splenomegaly was comfirmed and it was confirmed by autopsy of the experimental dog(No. 1).

• Archives of Plastic Surgery
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• 제47권2호
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• pp.187-193
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• 2020

Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

• 대한수의학회지
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• 제31권1호
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• pp.99-108
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• 1991

To observe the changes of serum proteins according to the process of Babesia gibsoni(B gibsoni) infection, the babesia protozoa($10^8/kg$) were inoculated into the cephalic vein of healthy dogs. The serum proteins of experimentally infected dogs were separated by using cellulose acetate electrophoresis. The results obtained were as follows; 1. Cellulose acetate electrophoresis was fractionated to total 6 of bands such as, albumin, ${\alpha}_1$, ${\alpha}_2$, ${\beta}_1$, ${\beta}_2$ and $\gamma$-globulin. 2. The concentration of total protein was shown a decreasing tendency after B gibsoni infection. Albumin and A/G ratio were lowered through all periods of the infection, but they were not significant changes. 3. The level of ${\alpha}_1$-globulin was significantly(p<0.05) incresed in early stage of the infection. 4. The levels of ${\alpha}_2$ and total $\alpha$-globulin were shown highly significant decreases (p<0.01) through all periods of the infection. 5. The levels of ${\beta}_1$ and total $\beta$-globulin had highly significant changes (p<0.01) that was increased in early stage of infection and decreased later. 6. The level of $\gamma$-globulin was seen to be constantly increased through all periods of infection. It was a highly significant change (p<0.01). 7. Plasma protein: fibrinogen (PP:F) ratio was shown a temporally significant increase (p<0.05) following the decrease in early infection.

• 대한수의학회지
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• 제31권1호
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• pp.89-97
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• 1991

For the ultrastructural observation on Babesia gibsoni(B gibsoni), the protozoa were challenged experimentally to splectomized dog. To examine the ultrastructure of the B gibsoni in the erythrocyte, the infected erythrocytes were collected at the cephalic or jugular vein of the dog. The results obtained by TEM(transmission electron microscopy) were as follows; 1. The sizes of protozoa in erythrocytes are $0.92{\pm}0.36{\mu}m{\times}0.67{\pm}0.21{\mu}m$, the sizes of nucleus of the protozoa are $0.55{\pm}0.24{\mu}m{\times}0.38{\pm}0.26{\mu}m$, and sizes of rhoptries in plasma of the protozoa are $0.33{\pm}0.05{\mu}m{\times}0.25{\pm}0.07{\mu}m$, respectively. 2. The tropozoite membrane in the erythrocyte was one, and it's nuclear membrane was made up of double. But the protozoa of initial stage in infected erythrocyte had double clear mambranes, and distinguished from plasma membrane of red blood cell. 3. The mitochondrialike structures covered with two membranes were observed in the protozoa. 4. Mitochondria and vesicles of the reticulocyte were observed near protozoa in the erythrocyte. 5. There are rhoptry, coiled structure and single nucleous in the merozoite. 6. The shape of rhoptry was round or ovoid form and in occasionally, the content of rhoptry was lost partially. 7. There was able to observe the dividing process of the protozoa. 8. Maurer's cleft-like structure was observed.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.143-148
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• 2001

전북대학교병원 정형외과에서 우측 제 1-5 수지가 모두 절단된 35세 남자에서, 우 수부 무지는 포장주위 피판(wrap around flap)시 제 1 배부 중수골동맥(the first dorsal metacarpal artery)의 고유 동맥(proper digital artery)을 제 1 배부 중족골 동맥(the first dorsal metatarsal artery)에, 두 정맥 분지(tributary of the cephalic vein)는 대 복재 정맥의 분지 (tributary of the greater saphenous vein)에 각각 문합하였고, 수부의 요골신경의 감각 분지는 거상된 포장 주위 피판의 심부비골 신경(deep peroneal nerve)에 신경 외막 봉합술을 시행하였다. 제 2, 3 수지 재건술에서는, 우 2, 3 족지의 족 배 동맥을 요골 동맥에, 대, 소 복재 동맥의 분지를 두 개의 두 정맥 분지에 각각 단-단 문합하였으며, 우 제 2, 3 족지의 표재 비골 신경을 요골 신경 분지에 신경 외막 봉합하였고, 동시에 우 제 2, 3족지의 지골 신경을 우 2, 3 수지의 지골 신경에 신경 외막 봉합하고 7년 추시하였으며, 우 수부 무지와 제 2, 3수지를 이용한 식사하기, 글씨 쓰기 그리고 양말 신기 등의 동작이 가능하였다.