• Journal of Chest Surgery
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• 제56권3호
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• pp.197-203
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• 2023

Background: The survival benefit of coronary artery bypass grafting (CABG) using the bilateral internal thoracic arteries (BITA) is well known; however, the role of BITA in concomitant aortic valve replacement (AVR) and CABG has not been studied. Methods: We retrospectively reviewed patients who underwent concomitant AVR and CABG. Cases not using an internal thoracic artery and less than 2 bypass grafts were excluded. We enrolled 114 patients in this study. The mean follow-up duration was 61.5±43.5 months. Results: Forty patients (35.1%) underwent CABG with a single internal thoracic artery (SITA) and 74 patients (64.9%) underwent CABG with BITA. The preoperative clinical characteristics were not significantly different between the 2 groups, with the exception of a higher prevalence of atrial fibrillation in the SITA group. Postoperative mortality and morbidity were not significantly higher in the BITA group than in the SITA group. In the univariable analysis, the survival of the BITA group was similar to that of the SITA group (p=0.157). Multivariable analysis showed that only mean age was a predictor of death (p=0.042), but using BITA was not an independent predictor (p=0.094). In low-risk patients whose preoperative ejection fraction was >45%, the survival of the BITA group was significantly better than that of the SITA group (p=0.043). Conclusion: BITA use in concomitant AVR and CABG showed no difference in mortality compared to using SITA. Although its impact on long-term survival was inconclusive, BITA use can be considered for low-risk patients.

• 한국임상수의학회지
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• 제41권4호
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• pp.228-233
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• 2024

A 7-month-old, 5.2 kg spayed female Norwegian Forest cat was referred for chronic, non-weight-bearing lameness in the left pelvic limb that has been present since 3 months old and has not responded to medical conservative therapy. Based on orthopedic and radiographic examination, concomitant cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL) of the left hind limb were diagnosed. In this case, cranial tibial wedge osteotomy (CTWO) was adopted to overcome side effect of performing other osteotomy techniques such as impairing the growth plates in the proximal tibia. Additionally, patient-specific surgical guides were applied to improve surgical accuracy. The patient showed an improvement in weight-bearing scores and gait condition during follow-up periods without complications. In our case, CTWO combined with corrective surgery for MPL can be used to treat concomitant CCLR and MPL without damaged on the growth plates and shows good clinical outcomes in an immature cat. Furthermore, the use of a surgical guide facilitates surgical procedures that minimize surgical error and increase surgical precision. This case study suggests that CTWO assisted by patient-specific surgical guides may be a viable surgical option for treating an immature cat with concomitant CCLR and MPL.

• 생물정신의학
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• 제6권1호
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• pp.74-80
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• 1999

본 연구는 항정신병약물의 하나인 클로자핀 사용에 따르는 중요한 부작용 중의 하나인 경련의 기전을 이해하기 위하여 시행되었다. 기존의 클로자핀에 의하여 유발되는 경련모델은 실제 임상상황에 적용시키는데 난점이 있으므로 다른 연구자들의 모델을 변화시켜 본 연구에 이용하였다. 정신분열병의 병태 생리에 단가아민가설이 아직 중요한 위치를 점하고 있을 뿐 아니라, 클로자핀에 의하여 유발되는 경련과 단가아민의 관련성을 시사하는 몇몇 증거에 준하여, 단가아민에 작용하는 약물들이 이 모델에서 어떤 영향을 주는가를 관찰하였다. 연구결과는 다음과 같다. 1) 할로페리돌, 프로프라놀롤, 플루옥세틴의 1회 병합처치는 클로자핀에 의하여 유발되는 간대성 근경련을 감소시켰다. 리탄세린 1회 병합처치는 이 경련에 영향을 주지 않았다. 2) 이미프라민 및 리탄세린의 장기 병합처치는 클로자핀에 의하여 유발되는 간대성 근경련을 증가시켰으며, 플루옥세틴 장기 병합처치는 이 경련을 감소시켰다. 할로페리돌 장기 병합처치는이 경련에 영향을 주지 않았다. 이상의 연구결과는 클로자핀에 의하여 유발되는 간대성 근경련에 도파민, 세로토닌계가 관여되나 노르아드레날린계는 관여되지 않음을 시사한다. 향후 단가아민계 신경전달물질의 수용체 아형에 따른 경련에의 영향을 살펴보는 실험이 보완될 필요가 있다. 이런 실험들을 바탕으로 클로자핀에 의하여 유발되는 경련에 대한 기전이 구체화되고 이에 따른 효율적인 관리지침이 세워지기를 기대한다.

• Journal of Chest Surgery
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• 제51권2호
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• pp.153-155
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• 2018

Concomitant rupture of the subclavian vessels and the left main bronchus caused by blunt trauma is a serious condition. Moreover, the diagnosis of a tracheobronchial injury with rupture of the subclavian vessels can be difficult. This report describes the case of a 33-year-old man who suffered from blunt trauma that resulted in the rupture of the left subclavian artery and vein. The patient underwent an operation for vascular control. O n postoperative day 3, the left main bronchus was found to be transected on a computed tomography scan and bronchoscopy. The transected bronchus was anastomosed in an end-to-end fashion. He recovered without any notable problems. Although the bronchial injury was not detected early, this case of concomitant rupture of the great vessels and the airway was successfully treated after applying extracorporeal membrane oxygenation.

• 한국임상수의학회지
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• 제18권1호
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• pp.48-54
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• 2001

The effects of PMSG and/or prostaglandin analogue, cloprostenol, on the prevention of implantation, termination of pregnancy, concentration of plasma progesterone, and Na and K contents of the plasma and uterine fluid were studied in pregnant rats. PMSG 50 or 100 IU concomitant with cloprostenol 90 or 180 mg were administered once on day 3 or 9 of gestation. Rats were autopsied on days 8, 10 or 21 gestation. A single administration of PMSG resulted in increasing the number of corpora lutea, preventing implantation and terminating pregnancy. A single administration of cloprostenol had no effect on the prevention of implantation and termination of pregnancy but was able to induce the termination of pregnancy administering at large doses on day 9. A single administration of PMSG concomitant with cloprostenol ws found to be very increased the number of corpora lutea and to be 100% effective in preventing implantation and to be nearly 100% effective in terminating pregnancy. It is uncommon that a single dose of PMSG 50 IU concomitant with cloprostenol 90 or 180 mg on day 9 was able to maintain the pregnancy at very low rates of 0.3∼5.3%. Concentration of plasma progesterone and Na and K contents of the plasma and uterine fluid were increased or decreased administering PMSG and/or cloprostenol, but had no effect on preventing implantation and terminating pregnancy.

• Journal of Chest Surgery
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• 제25권9호
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• pp.962-967
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• 1992

Eight patients with proven clinical stage Ill lung carcinoma of which six were epidermoid cell carcinoma and two were small cell carcinoma underwent concomitant radiation therapy and chemotherapy before surgical resection from March 1990 to February 1992 at the thoracic surgical department, Yongdong Severance Hospital, Yonsei University College Medicine The therapy consisted of more than one cycle of chemotherapy every 4 weeks and concomitant irradiation. Three to four weeks after chemotherapy and radiation therapy, the patient were reevaluated for thoracotomy and pulmonary resection. Two patients were found to have unresectable lesions and, radiosotopes were implanted to the remaining tumors. Three patients had complete pneumonectomies and two patients had pericardial penumonectomyo. Only one patient had complete pneumonectomy & concomitant resection of ribs attached to tumors with reconstruction of chest wall with Marlex mesh. Complete sterilization of lung tumor and mediastinal nodes proven histologically was achieved in 2 patients, without operative mortality. The median survival of all patients was eight months, but the median survival of survivors which lung tumor were completely resected completely and whose pathologic reports showed stage I or 0, was about 18 months to now. The overall result indicates some benefit from this preoperative chemotherapy and radiation therapeutic regimen in patients with advanced unresectable lung cancer.

• 대한한의학회지
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• 제21권4호
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• pp.129-137
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• 2000

Objectives: The aim of this study was to investigate the attitude toward the oriental hospital among 1,234 outpatients. Methods: A questionnaire about the general characteristics of patients, the decision-maker of use and the reason of choice or alteration was implemented. Results: The results of this survey as follows: Among outpatients 56.4 % were female in sex, 25.6 % were below 9 years of age; in educational level, 50.1 % were college graduates. Among outpatients, 33.6% chose the oriental hospital as their first choice and the rest were recommended by other persons. The recommenders were mostly relatives(73.9 %), female(73.4 %), young(30-39 years old, 40.1 %), high educational level (above the college, 54.9 %) people. 37.8 % among outpatients were secondary selection after the western medical clinic for the same symptom and sign. 7.0 % were the concomitant users of both therapies. 62.8 % among the concomitant users did not notify the western doctor about the dual therapies. The reasons they did not notify their Western doctors were 'be afraid of western doctor s bias' (42.6 %), 'no special reason' (29.6 %). Conclusions: The appropriate transfer system between oriental and western clinic must be constructed and the proper recognition about dual therapies will be needed among patients and doctors who practice both kinds of medicine.

• 한국임상수의학회지
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• 제16권2호
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• pp.389-396
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• 1999

Pregnant rats were treated at various stages of gestation with prostaglandin analogue, cloprostenol alone or concomitant with HCG to study effects on termination of gestation and plasma estrogen and progesterone. Cloprostenol (90 or 180 mg/kg) was administered alone on 1~3, 4~6, 7~9, 9~11 or 11~13 consecutive days of gestation twice a day and in combination with HCG (50 or 100 IU/day) on days of 1~3 or 7~9 once a day. Rats were autopsied on day 21 of gestation or at 6, 12 or 24 hours after treatment on day 6 or 9, respectively. Cloprostenol was found to be nearly 100% effective in preventing implantation, destroying viable fetuses and causing preimplantation losses, but in early gestation, on days 1-3, there was little effect. And when cloprostenol administered concomitant with HCG, corpora lutea were significantly increased, implantation sites and viable fetuses significantly decreased, and pre-and post-implantation losses significantly increased in most cases. Plasma concentrations of estradiol and progesterone were significantly decreased by administering cloprostenol, and estradiol concentration significantly decreased but progesterone significantly increased by administering of cloprostenol concomitant with HCG. It is suggested that cloprostenol was more effective in terminating pregnancy than a combination of cloprostenol and HCG in the rat.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.19-25
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• 2008

Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.

• Toxicological Research
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• 제12권2호
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• pp.223-230
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• 1996

The increased embryotoxicity of the antifolate drug pyrimethamine (PYM) with concomitant dietary dosing of folic acid (FA) was examined in mice. The preventive effects of folinic acid (FNA) on PYM embryotoxicity were also examined. Six groups were constructed: PYM I (pyrimethamine 80 ppm), PYM II (pyrimethamine 150 ppm), PYM II+FNA (pyrimethamine 150 ppm and folinic acid 12 mg/kg/day), PYM II+FA (pyrimethamine 150 ppm and folic acid 350 ppm), FA (folic acid 350 ppm) and a control group. The agents were administered for 7 days from day 6 throughout 12 of gestation. PYM and FA were administered with mashed feed and FNA was intraperitoneally injected. The high incidence of fetal realformations was observed in the PYM II group; these included kinky tail, open eyelids, club foot, cleft palate, absence of the pulmonary lobe, diaphragmatic hernia, fused sternebrae, fused cervical or thoracic vertebral arch, among others. All embryos of the PYM II+FA group were resorbed. No realformed fetuses were observed in the PYM II+FNA group. These results show that the concomitant dosing of FA augments PYM embryotoxicity. The preventive effects of FNA were also observed.