• Journal of Chest Surgery
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• 제41권1호
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• pp.95-97
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• 2008

허혈성 좌심실벽 파열은 심근경색 후에 발생하는 치명적인 합병증 중의 하나인 심장파열의 한 유형으로 빠른 진단과 수술이 필요하다. 환자는 내원 15분 전 갑작스런 의식소실을 주소로 내원한 75세 여자로 당시 의식은 반 혼수상태로 얼굴과 상하지에 청색증 소견을 보였으며 응급실에서 시행한 심초음파 검사상 심낭에 약 $1.5{\sim}2\;cm$ 두께로 삼출소견이 관찰되었으며 심장박동 수가 35회/분까지 떨어져 심장마사지 시행하면서 응급수술을 시행하였다 우심실 전벽에 1 cm정도의 파열과 좌심실 벽에 괴사성 출혈반흔을 동반한 파열부위를 확인하고 체외순환 없이 사친스키 겸자를 이용해 출혈부위를 잡은 뒤 봉합하였다. 환자는 수술 후 28일째 약간의 호흡곤란은 있으나 일상생활 가능한 상태로 퇴원하였다.

• Journal of Chest Surgery
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• 제44권2호
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• pp.148-153
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• 2011

Background: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. Materials and Methods: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. Results: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. Conclusion: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.

• Journal of Chest Surgery
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• 제44권2호
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• pp.142-147
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• 2011

Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.

• Journal of Chest Surgery
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• 제41권1호
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• pp.124-127
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• 2008

외상에 의한 하대정맥의 손상은 사망률이 매우 높으며, 1970년대 이후로 사망률의 개선이 거의 없는 실정이다. 특히 간 후부 하대정맥의 손상은 사망률이 대개 75% 이상이며, 이는 시야확보와 지혈 등의 수술적 어려움에 기인한다. 하대정맥 손상 환자의 생존은 손상의 심한 정도와 해부학적 접근가능성 등과 연관이 있다. 총상에 의한 간 후부 하대정맥 손상환자의 수술을 경험하였기에 문헌 고찰과 함께 보고한다.

• 한국항공우주학회지
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• 제42권9호
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• pp.745-751
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• 2014

멀티 노즐로 구성된 추진기관의 경우, 각 노즐별 노즐마개 파열압력의 편차가 초기 분력을 유발하고 유도탄의 비행안정성에 영향을 미친다. 따라서 노즐마개 설계 시 먼저 형태별로 파열거동을 분석하여 원하는 파열압력에서 균일하게 파열되는지를 확인해야 한다. 본 연구에서는 평판형, "+" 노치형 노즐마개에 대한 파열거동을 실험적, 해석적인 방법으로 분석하였다. 실험 시 저장온도, 노치의 유무, 노치방향에 따른 노즐마개 파열압력 및 편차를 분석하였다. 그리고 유한요소해석을 통해 노즐마개의 파열거동을 순차적으로 분석하고, 그 결과를 실험값과 비교하여 정확성을 검증하고자 하였다. 해석 시 상용프로그램인 Abaqus/Explicit를 사용하였고, 파손모델은 Johnson-cook 전단파손모델을 적용하였다.

• 대한한의학회지
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• 제21권1호
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• pp.84-90
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• 2000

Background and Purpose: Stroke in young adults is relatively uncommon. Only 3.7-14.4% of all strokes occur in patients aged 15-45 years. Stroke in young adults has more various and diverse possible causes than stroke in the elderly. We studied to gain further insight into both pathogenic and etiologic determinants in young adults with stroke. Methods : We retrospectively reviewed the medical records of 230 young patients aged 15-45 years who were admitted to the 2nd internal medicine department of Kyung Hee Oriental Medical Center with a diagnosis of stroke between May 1995 and May 1999. We analysed clinical features and diagnostic tests, such as brain imaging, cerebral angiography, echocardiography, 24 hours holter monitoring and other laboratory tests. Results : 1. Of 230 young patients with stroke aged 15-45 years(176 males(76.5%) and 54 females(23.5%)), 140 patients(60.9%) showed ischemic stroke and 90 patients(39.1 %) showed hemorragic stroke. 2. The most prevalent age group was from 40 to 45 years with 142 patients(61.7%) 3. The most frequent site of 140 ischemic stroke was MCA territory in 93 cases(66.4%) and Multiple, VA territory, PCA territory, ACA territory in order of frequency. 4. The most frequent site of 90 hemorrhagic stroke was basal galglia hemorrhage 57 cases(63.3%) and subcortical 13 cases(14.5%), pons, thalmus, subarachnoid, cerebellum in order of frequency. 5. The causes of hemorrhagic stroke were hypertension 49 cases(54.5%), arteriovenous malformation 7 cases(7.8%), ruptured aneurysm 4 cases(4.5%), angioma 3 cases(3.3%). 6. The risk factors of ischemic stroke were smoking, alcohol drinking, hyperlipidemia, hypertension, obesity, heart disease, history of CVA, diabetes mellitus, in order of frequency. 7. The comparison of risk factors between ischemic and hemorrhagic stroke: hypertension was prevalent in hemorrhagic stroke, heart disease and history of CVA were prevalent in ischemic stroke. Conclusions: From the above results, we found that stroke in young adults had various possible causes. Young adults with stroke deserve an extensive but tailored evaluation which include angiography and echocardiography for diagnosis.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.226-231
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• 2009

Objective : We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. Methods : Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. Results : Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. Conclusion : Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.

• 한국임상수의학회지
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• 제23권1호
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• pp.81-85
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• 2006

Complete ruptures of the Achilles tendon were repaired in two hunting dogs of a 3-year-old, 20 kg and a 4-year-old, 14 kg with non weight bearing lameness. Both dogs were injured by wild animals and the skin defect was showed on the caudal surface of the right limb. Surgical repair involved the attachment of the ruptured tendon with a three-loop pulley method, using nonabsorbable suture materials. After surgical procedure, a bivalved cast was applied and maintained for 6 weeks. Exercise was restricted for 2 weeks more before gradually returned to normal. Gait and standing posture of dogs were returned to normal during the follow-up of 10 weeks.

• 한국식품과학회지
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• 제24권5호
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• pp.477-481
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• 1992

품질이 좋은 된장을 제조하기 위한 연구의 일환으로 재래식 된장과 Aspergillus oryzae와 Bacillus natto를 혼합한 된장을 제조해서 발효기간에 따른 대두조직의 변화를 조사한 결과 가압, 가열처리에 의하여 세포벽이 붕괴되거나 ghost 상태를 보였고 표피부와 내부의 세포질은 원형질 분리가 현저한 차이가 있으며 protease에 의한 당단백 구상체의 융합과 amylase에 의하여 전분이 분해되어 작은 공포를 보였으며 발효에 의한 균침투 과정이 시일이 경과함에 따라 표피부에서 내부로 이행되어지며 Aspergillus oryzae와 Bacillus natto 혼합 된장의 표피부와 유세포에서 점질물이 보인다. 또한 발효시간이 경과함에 따라 염색성이 나빠지고 세포벽이 다각형으로 되는데 재래식 보다는 Aspergillus oryzae와 Bacillus natto 혼합구가 현저하였다.

• Journal of Acupuncture Research
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• 제22권4호
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• pp.155-163
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• 2005

Objectives : This is a clinical report about neurogenic bladder patient with lumbar disc hernication. Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination. Hypotonic (flaccid) neurogenic bladder can be caused by ruptured or herniated intervertebral disk. Methods : The patient was treated by Oriental medicine treatment with needle acupuncture, electropuncture, bee venom acua-acupuncture and Daeboonchungeum-gami etc. Voided volume and frequency, visual analogue scale and physical examination was used to estimate the efficacy of these treatment. Results : STZ As using these treatments, voided volume and frequency returns normal condition. Visual analogue scale dips as low as 2. Physical examination showed improvement as compared with the fist visit. And further, these treatment may influence on the recovery of neurogenic bladder patient with lumbar disc herniation. Conclusion : The results suggest that Oriental medicine treatment have an useful effect on neurogenic bladder patient's treatment and recovery.