외상성 횡경막 허니아

장봉현,한승세,김규태,Jang, Bong-Hyeon,Han, Seung-Se,Kim, Gyu-Tae 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.4

The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

만성 교약성 심낭염의 외과적 치료

장봉현,김규태,Jang, Bong-Hyeon,Kim, Gyu-Tae 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.2

Records of 15 patients who underwent operation for constrictive pericarditis at this department from 1976 through 1984 were reviewed. All had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. There were 12 males and 3 females in this series. Range of age varied from 7 years to 51 years. Clinical and histological study revealed granulomatous pericarditis compatible with the diagnosis of tuberculosis in 5 patients, non-specific chronic inflammatory changes in 6 patients and pyogenic pericarditis in 2 patients. Pericardiectomy was performed through a median sternotomy [11 cases] or bilateral anterior thoracotomy [4 cases]. The postoperative complications were observed in 4 patients. Low cardiac output was the most common complication [2 patients]. In 13 cases, excluding 2 operative deaths, preoperatively all were in New York Heart Association Class III or IV. At the time of discharge II [85%] were in Class I or II. 4 Cases were reoperated after original pericardiostomy and all resulted in marked improvement. Early surgical intervention is advisable in all patients in whom cardiac constriction is caused by either a thickened pericardium or a pericardial effusion before myocardial dysfunction occurs.

좌심저형성 증후군 경험 1

장봉현 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.2

An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

승모판막질환의 판막재건술36례 성적

장봉현,한승세,김규태,Jang, Bong-Hyeon,Han, Seung-Se,Kim, Gyu-Tae 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.1

From January 1962 to March 1987, 97 patients underwent operation for mitral valve disease. Of these patients, 61 [62.9%] required mitral valve replacement. Thirty-six patients [37.1%] had mitral valve repair. The mean age was 26.9*11.6 years [range 5 months to 48 years]. There were 32 [88.9%] cases of rheumatic valve disease, 4 [11.1%] cases of congenital mitral valve disease. Valve dysfunction was classified into three types: type I [normal leaflet motion], 6 patients; type II [prolapsed leaflet], 1 patient; type III [restricted leaflet motion], 29 patients. Twenty-nine patients [80.6%] had pure or predominant stenosis and 7[19.4%] had pure regurgitation. No patient was in NYHA functional class I. Three patients [16.7%] were in functional class II, 15[83.3%] were in functional class II. The techniques used included closed mitral commissurotomy [16 patients], open mitral commissurotomy [13 patients], localized Wooler type annuloplasty [4 patients], suture repair of leaflet defect [3 patients], chordal shortening [1 patient], Carpentier ring annuloplasty [1 patient], and fenestration of fused chordae [1 patient]. There were two perioperative deaths [5.6%], related to left ventricular failure and reoperation. The survivors were followed up for 94 patient-years [mean 4.68*5.54 years]. One late death [1.1*1.1% per patient-year] occurred and was valve related. Reoperation was required in 3 patients, of whom 2 were deaths. There was 1 case [1.1*1.1% per patient-year] of thromboembolism. No patient received anticoagulant after operation. At 10 year, 92*7.4% of the patients were still alive. The actuarial survival rate of patients free of valve-related complication was 79*6.4% at 6 years, 27*12.1% at 11 years. After surgery, 18 patients [88.9%] were in NYHA functional class I or II.

매설관의 동적거동에 대한 수치적 해석 접근(1)

장봉현(Jang Bong Hyon),정진호(Jeong Jin Ho),이병길(Lee Byong Gil) 대한토목학회 2003 대한토목학회 학술대회 Vol.2003 No.10

경북대학교 의과대학의 문제중심학습 시행과 그 평가

장봉현(Bong Hyun Chang),이유철(Yoo Chul Lee),김보완(Bo Wan Kim),강덕식(Duk Sik Kang),곽연식(Yun Sik Kwak),강이철(E-cheol Kang),서강석(Kang Suk Seo),김인겸(In Kyeom Kim),이종명(Jong Myung Lee),정성훈(Sung Hoon Jeong),김종열(Jong Yeol 한국의학교육학회 2001 Korean journal of medical education Vol.13 No.1

문제중심학습 (PBL)은 주어진 실제 환자문제를 학생 스스로 파악하여 학습과제를 설정하며, 학습한 내용을 논리적으로 적용하여 타당한 가설을 세워가는 과정을 거침으로써 학습이 이루어지는 새로운 교육 방법이다. 경북대학교 의과대학은 PBL을 도입하기 위하여 캐나다의 McMaster 의과대학을 단기 방문하여 그곳의 의학교육을 경험하고 PBL의 필요성을 절감하여, 1994년부터 2년간 시범적으로 PBL 수업을 운영한 후, 2년간 평가와 보완기간을 가졌다. 1994년부터 1996년까지 전학기에는 4학년과 3학년, 후학기에는 3학년과 2학년을 대상으로 6명을 한 조로, 45개의 소그룹을 만들고, 각 조에는 한 명의 지도교수를 배정하여 격주로 목요일 4교시에 PBL수업을 진행하였다. 설문조사 결과 4학년은 55.1%가, 3학년은 61.4%가 PBL이 필요하다고 응답하였으며 교수들은 83.9%가 필요하다고 답하였다. 이와 같은 결과에 근거하여 1999년도부터 시작하는 개편된 의학교육과정에 PBL이 정규과목으로 채택되었고, 이에 대비하여 1998년도 2학기에 의예과 2학년 학생을 대상으로 하여 PBL을 시행하여 그 결과를 평가하였다. 1999년도에는 의학과 1학년을 대상으로, 2000년도에는 의학과 2학년까지의 학생을 대상으로 PBL수업을 실시하였다. 본 연구자들의 조사에서, 학생들이 PBL에 대하여 상당히 이해하고 있으며, PBL의 학습목적을 대부분 달성한 것으로 나타나, 정규과목으로서의 PBL 시행에 전반적으로 긍정적인 평가를 한 것으로 판단되며, 조사결과에서 나타난 단점과 부족한 부분을 보완하고 개선한다면 PBL를 정착시키고 점차 확대 시행할 수 있을 것으로 생각된다. The effectiveness of Problem-based Learning (PBL) in medical education has already been acclaimed widely. Representatives of the curriculum committee at Kyungpook National University School of Medicine paid a visit to McMaster University School of Medicine in Canada in May, 1994 in order to learn mechanics and effectiveness of PBL in its medical education and they were impressed by the efficacy of PBL. Soon after that the school launched a pilot PBL tutorial for two years from 1994 through 1996 (4-semester) as a non-credit course for senior, junior and sophomore in medical school during one semester each, to introduce PBL to faculty members and students as well. After the pilot, opinion survey on PBL from both faculty and students revealed affirmative for PBL from 55.1% of seniors, 61.4% of juniors and 83.9% of faculty members. The faculty body at medical school was then encouraged by the pilot experience and decided to include the PBL as the part of medical education reform. During the fall semester in 1998, the senior at pre-medical course was given PBL experience to prepare for implementation of PBL at school of medicine. The PBL was implemented as an essential 2-credit-hour course in each semester commencing in 1999 to the freshmen class throughout the year; it was extended to the sophomore in 2000 and to the junior in 2001. Although there had been initial excitements of over expectations, confusion, and disappointments from faculty members and students, majority opinion of both parties on continuation of PBL was positive. The issues to be settled are preparation of study cases, students learning resources, and method of evaluating students performance. The PBL was started as an essential course in medical school in 1999 after 4 years of preparation and on the basis of our interim evaluations the following conclusions were made: we have reached the following consensus that students seem to follow the objectives of PBL and new PBL tutorial has well been accepted by students; and enhancing the program by correcting currently known weaknesses, the PBL tutorials could further be expanded to be a major modality of teaching in our medical school.

매설관의 동적거동에 관한 연구 (2)

장봉현(Jang Bong Hyon),정진호(Jeong Jin Ho),이병길(Lee Byong Gil) 대한토목학회 2004 대한토목학회 학술대회 Vol.2004 No.10

자동차 정비업소에서의 석면섬유 및 총분진 농도

장봉기,김인화,이상림,한진이,황수민,조봉현,김영지,허은협,이종화 순천향대학교 기초과학연구소 2015 순천향자연과학연구 논문집 Vol.21 No.1,2

We collected total 45 samples of asbestos fibers and total dust concentration by 2 personal sampling and 1 area sampling method from 5 auto repair shops in Asan city for 3 days. The results are as below. Asbestos fibers in the air of 30 samples from auto repair shops by mixed cellulose esters (MCE) filters were  ×   fiber/cc. It is very low, so it is not reach to the standard of permission of indoor air quality which is 0.01 fiber/cc. In 17 of 30 samples, asbestos was detected, but they are lower than quantitative limit. According to sampling media, total dust concentration collected by MCE filters (140.3㎍/㎥) is significantly higher than PVC filters (95.7㎍/㎥), but it is much lower than the occupational exposure limit which is 1st class of dust (2,000㎍/㎥), and there is no difference on number of repairing and number of exchange of brake lining. According to the result, the concentration of asbestos fibers and total dust in auto repair shops are much lower than standard of permission. They are lower than quantitative limit, so it is considered that there are no brake linings or brake pads which have asbestos have been repaired.

내리막 일반 도로변에서의 공기 중 석면섬유 및 총분진 농도

장봉기,김다운,김대준,안지희,이솔,조봉현,김영지,허은협,이종화 순천향대학교 기초과학연구소 2015 순천향자연과학연구 논문집 Vol.21 No.1,2

We analyzed 60 samples of asbestos fibers and total dust concentration in ambient air at the uphill and downhill of busy roadside in 5 areas in Asan city. Concentration of asbestos fibers in ambient air on downhill side (75.8×10⁻⁶ fiber/cc) was higher than one on uphill (37.3×10⁻⁶ fiber /cc), but, it was not statistically significance different. Both of them were even less than the standard of permission of indoor air quality which is 0.01 fiber/cc. Total dust concentration collected by mixed cellulose esters (MCE) filter (147㎍/㎥) was significantly higher than one collected by poly vinyl chloride (PVC) filter was 81㎍/㎥ (p<0.01). According to traffic, the more passing vehicles, the more total dust concentration. Diesel trucks influence on increasing total dust concentration (p<0.05). Regarding the result, vehicles which have brake linings and pads that contain asbestos fiber are considered that not be driven on the general road anymore. Increasing diesel trucks influence on increasing total dust concentration, and it is caused by respirable particulate in exhaust gas from diesel vehicles.

지적좌표의 세계측지계 변환에 관한 국지적 실험

장봉배,유창현 한국국토정보공사 2010 지적과 국토정보 Vol.40 No.1

2009년 12월 제정 시행된 “측량·수로조사 및 지적에 관한 법률”에 의하면 새롭게 등록되는 확정측량 지역 및 토지개발사업 지역 등은 세계측지계(世界測地系)에 따라 지리학적 위치를 등록해야만 한다. 따라서 안정적이고 효율적인 세계측지계의 도입은 지적 분야에 있어서 매우 중요한 사항이라 할 수 있다. 이와 관련하여 본 연구는 다각형의 무게중심점을 기본으로 지적측량좌표 변환 프로그램을 개발하여, 디지털지적구축 시범사업지구를 대상으로 GPS에 의하여 실측된 세계좌표와 비교함으로써 프로그램의 성능을 검증하였다. 검증결과 X는 0.57cm, Y는 1.21cm의 평균제곱오차를 보여 근사적인 지적도 변환에 사용할 수 있는 것으로 판단되었으며, 향후 사용자 중심의 다양한 부가기능 개발과 정확도 향상으로 더욱 정밀한 지적측량의 세계측지계 도입 및 안정화에 긍정적 효과가 있기를 기대한다. The geographic position of confirmation survey and estate development areas should be registered with respect to the world geodetic reference system, which is based upon recently enacted “law on survey, hydrographical inspection and cadastre” on December 2009. Therefore, it is very important to bring in the stable and efficient world geodetic reference system in cadastral field. In this study, the cadastral survey coordinates transformation program invented based on a polygonal centroid is applied to convert the coordinate of a region in which digital construction project is being carried out. In this process, the capability of program is verified by comparing the coordinate measured by GPS. As a consequence, the result of verification is that the mean square errors are “x=0.57cm,” “y=1.21cm.” It is estimated that this result does not make big difference when applied to cadastral survey. It is expected that the introduction of coordinate for cadastral survey will be pretty affirmative hereafter with a variety of extra functions for customers and accuracy improvement.