부종환자에서 임피던스를 이용한 수분변화의 예측

오중환 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.11

The assessment method of human body composion by bioelectrical impedance is very simple, safe, rapid and noninvasive. Based on prediction formulas for total body water from bioelectrical impedance, the observed weight loss should be associated with an increase in impedance. However in edematous patients for dialysis, the calculated total body water loss as calculated from impedance were overestimated and significantly higher than the weight loss after dialysis. So determination of impedance were made in 50 edematous patients before, during and after dialysis. Mean weight loss, which was assumed to be only loss of water was 1719$\pm$ 866 gr and mean impedance change was 71.0 $\pm$ 23.0 Ohm under 50kHz. Body weight loss was highly correlated [r>0.81 with the increase in body impedance under variable frequencies[1, 10, 20, 30, 40, 50 kHz . But there were no differences between frequences. In conclusion, clinical application of bioelectrical impedance method is useful for individual edematous patients with new correlation equation[Y=230+26.8X, X;Impedance change, Y;Calculated total body water loss .

골격근 심실의 역학

오중환 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.5

배경: 전기적인 자극에 의하여 골격근의 피로현상이 극복됨으로써 골격근을 심장보조장치에 이용할 수 있게 되었다. 인공심장이나 심실보조기구는 에너지원의 전원장치가 크고 거추장스러운 단점이 있어 아직 해결해야될 문제이다. 반면 골격근을 이용한 심실보조장치는 에너지원으로 환자 자신의 골격근 수축력을 이용할 수 있는 장점이 있어 이의 임상응용 가능성을 제시하고자 한다. 대상 및 방법: 8예의 광배근을 이용하여 골격근 심실의 모형을 만들었다. 물이 담긴 라텍스 주머니를 골격근이 한바퀴 반 감싸도록 고안하였고 골격근의 수축압력은 연결된 관을 통하여 변환기에 기록되도록 하였다. 전극은 흉배신경 주위에 설치한 후 Itrel 7420 박동기에 연결하였다. 프로그래머로 박동기를 조절하였으며 3.0Volt, cyclic burst, 0.31초 on time, 6.0초 off time의 자극을 주었다. 라텍스 주머니 내에 액체의 양을 25cc 씩 증가시키면서 전부하의 변화에 따른 골격근 심실의 박출량과 압력 및 수축력을 측정하였다. 결과: 골격근 심실의 전부하가 0인 경우 일회박출량은 76.3ml 이고, 전부하가 점차 증가함에 따라 일회박출량이 감소하는 경향을 보였다. 전부하가 75cc 이상이 되면 일회박출량은 70ml 이하로 감소하는 양상을 볼 수 있었다. 압력을 측정한 결과도 전부하가 75cc 이하인 경우 정상의 혈압과 비슷한 107mmHg 이상의 혈압을 보이고 있으나 전부하가 100cc 이상 증가하는 경우 혈압이 100mmHg 이하로 감소하는 것을 볼 수 있었다. 또한 최대의 골격근 수축력은 50cc의 전부하에서 16.6 W/kg의 힘을 분출하였다. 결론: 골격근 심실은 전부하의 변화에 따라 정상 심장보다도 강한 박출량과 압력의 변화를 관찰할 수 있었으며 임상 응용의 가능성을 볼 수 있었다. Background: It has been shown that low-grade electrical stimulus can transform fatigue resistant muscles which then can be used to protect the heart. The bulky and cumbersome power sources of the artificial heart or implantable ventricular assist devices are still in need of solution; however, on the other hand, the implantable ventricular assist devices using the resistant muscles as the power source have the advantages of using its own muscle contractions. The purpose of this study was to determine the possibility of a clinical application of the skeletal muscle ventricle. Material and Method: Latissimus dorsi muscles (LDM) of 8 canines were used for skeletal muscle ventricle. A latex chamber was wrapped one and a half times with LDM. The chamber was attached to a pressure transducer via Tygon tube. An electrode stimulator was placed around the thoracodorsal nerve and LDM was stimulated in cyclic bursts of 0.31 sec on time and 6.0 sec off time using 3.0 volt Itrel stimulator. The preload volume was added to the system in 25cc increments. Ejection volumes, pressures, and peak power outputs were measured. Result: Ejection volume was 76.3cc with 0cc of preload. Ejection volumes were less than 70ml with increments of preload over 75cc Pressures were more than 107 mmHg when the preloads were less than 75cc and less than 100 mmHg when the preloads were more than 100cc. Peak power output of 16.6 W/kg was observed at 50cc preload. Conclusion: Depending on the changes of preload, the volumes ejected from skeletal muscle ventricle and pressures from the skeletal muscle contraction surpassed those of the normal heart. These data suggest that there are clinical applications for skeletal muscle ventricular assist system.

항암제독탕가제조와 항암양제방에 대한 비교연구

오중환,박종형,한양희,김동우,전찬용,백은기,홍의실,한지완,임영남 대한한의학회 2003 대한한의학회지 Vol.24 No.3

Objective : Though modern medicine has made various studies in cancer treatment, the results of the treatments are not satisfactory. Considering this, Oriental medicine can be a breakthrough in treatment of cancer, and therefore, its constant research eagerly needed. According to preceding studies, Hangamjedoktang (Kangaizhidu-tang) with Hagocho appeared to be statistically significant against cancer, and therefore to seek a better medication for cancer, Holotrichia which seemed to be effective against cancer was added to the formula, and herbs which showed an anti-tumor effect in preceding studies composed Hangamyagjaebang. The efficacy of both Hangamjedoktang with Holotrichia (HJJ) and Hangamyagjaebang (Kangaiyaocaijang) (HM) was compared. Methods : To examine the anti-cancer effect of HJJ and HM, inhibitory effect on solid tumor growth in mice induced by Sarcoma-180 (s-180), change of body and organ weight in tumor bearing mice and the activity of machrophages and lymphocytes in the spleen were examined. Results : 1. In the HJJ and HM treated groups, tumor growth was markedly decreased. 2. HJJ and HM increased the activity of ALP which is produced from the splenocytes transplanted with S-180. 3. HJJ and HM increased the ACP activity of the macrophages of the mice transplanted with S-180. Conclusion : These results suggest that HJJ and HM are good candidates for new drugs for cancer therapy.

葡萄晩腐病防除를 위한 各種殺菌劑의 比較

오중환 안성산업대학교 1971 論文集 Vol.3 No.-

1. 各 殺蟲劑들이 葡萄晩腐病防除에 미치는 效果는 Tuzet, Difolatan>Bordeux,Daconil의 順으로 效果가 좋았다. 2. 現在 장려하고 있는 Daconil 30gr/18ℓ에 희석 살포하는 것은 만부병 방제효과를 나타내기에는 약한 것 같다. 3. Tuzet 과 Difolatan은 枝稍와 果實에 심한 약해가 유발되었다. 4. Dithane 과 Daconil 은 안심하고 사용할 수 있었다. To find out the most effective ones among the several fungicides being applicable to ripe rot in Grape growing, several fugicides were com compared each other and following results were obtained 1. The order of effectiveness was Tuzet ≒ Difolation > Bordeux ≒ Daconil. 2. It seems that the current recommended 30 gr of Daconil per 18ℓ or water is too weak to be effective to the ripe rot. 3. Tuzet and Difolation have induced the chemical damaged on branches, shoots and fruits of grapes.

신장근접 대동맥 폐색증의 상복강대동맥 우회술

오중환 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.1

Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.

경식도 초음파로 진단된 외상성 대동맥 파열[1예 보고]

오중환 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.3

Truamatic aortic rupture is usually fatal if left untreated. Prompt diagnosis is the cornerstone of suscessful management. But the usual screening tests are non specific and the accuracy of computerized tomography is low, Aortography which is a time consuming procedure may result in false-positive interpretations and significant morbidity. Recently transesophageal echocardiography provides a rapid, effective and relatively safe means of evaluating the distal aortic arch and also affords the opportunity to evaluate the heart during the same study, which may be of benefit in cases of suspected cardiac injury. The experience with the traumatic aortic ruptured patient and a critical review of the literature suggests that transesophageal echocardiography is a useful technique for the diagnosis of ruptured aorta following blunt chest trauma.

자연기흉의 양측 기포 동시제거술 : 11예 보고 11 CASES

오중환,윤양구,정경영,이두연,조범구,방서욱 대한의학협회 1990 대한의학협회지 Vol.33 No.2

개심술후 출혈로 인한 응급 개흉술 81례의 임상적 고찰

오중환 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.4

Hemorrhage is an important complication after operation with cardiopulmonary bypass and sometimes necessitates a further emergency operation. Between July, 1962 and June, 1985, reoperation for hemorrhage was carried out on 81 patients [3.1%] out of a total 2634 patients who had previously undergone cardiopulmonary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Yonsei University Medical Center. There were 38 males and 43 females, with an average age of 25 years [ranging 6 months to 60 years] and an average body weight of 38 kg [ranging 5 to 77 kg].There were 43 patients of cyanotic heart disease, 32 patients of acquired valvular heart disease, 4 patients of coronary artery occlusive disease, 2 patients of ascending aorta aneurysm and annuloaortic ectasia. The average amount of blood loss in the case of cyanotic heart disease was 71.7140ml/kg, in acyanotic heart disease 45.16.3ml/kg, in acquired heart disease, 56.514.4ml/kg and in coronary artery occlusive disease, 50.618.7ml/kg during first post operative day. But there was no statistical difference [p>0.05]. The mean blood loss below 10 years old was 70.412.1 ml/kg. Those below 10 years old were believed to bleed more than any other group. But there was also no statistical difference [p>0.05]. Indications for reoperation were continued excessive blood loss [74%], cardiac tamponade or hypotension [23%] and radiological evidence of a large hematoma in the thorax and pericardium [2%]. Average bypass time was 2.10.1 hours [ranging 30 minutes to 5 hours]. The interval between operation and reoperation was as follows; less than 12 hours in 49 patients [60%], 12 to 24 hours in 20 patients [25%], 24 to 48 hours in 8 patients [10%], more than 48 hours in 4 patients [5%]. The commonest sites for bleeding were chest wall [36%], heart [34%], aorta [12%], pericardium [6%], thymus [5%] and others [6%]. But no definite source was found in ll patients [31%]. Twenty seven out of 81 patients [31%] had wound problems and 5 patients [6%] were expired. [Mean SEM]. In conclusion, in order to decrease the amount of blood loss after open heart surgery with cardiopulmonary bypass, shortening of bypass time and bleeding control at the wire suture site during chest wall closure were important. If the amount of blood loss was over 45 ml/kg or 8 m/kg/hour, reoperation should be considered as soon as possible. After operating, careful wound dressings were applied to prevent wound problems.

심외막 지방의 정량분석

오중환,강청희,이종국,O, Jung-Hwan,Gang, Cheong-Hui,Lee, Jong-Guk 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.3

Subepicardial space is one of the regions in which fat in moderate amount is normally deposited. When excess deposits of epicardial fat occur, penetration or infiltration of fat into the connective tissues between muscle bundles is observed. In some cases with very extensive involvement of epicardial fat,myocardial insufficiency and conduction system defect such as heart block have been implicated. More fat is deposited over the right ventricle than over left and the anterior surface contains more fat than dose the posterior surface. We studied 40 patients who underwent open heart surgery under the cardiopulmonary bypass. This study was designed to evaluate the percentage of the area of epicardial fat of the right ventricular anterior surface, which is more accessible area during the operative procedure. Other variables included thickness of subcutanous tissue of anterior chest wall, the ratio of waist to hip circumference, body weight and age. In conclusion, the amount of the epicardial fat correlates with thickness of the subcutaneous fat of the anterior chest wall and simple linear regression analysis indicates good correlation with body weight. Increased age results in large amount of epicardial fat.

체외순환시 호기말 이산화탄소압의 변화

오중환 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.12

The evaluation of the effectivess of ongoing cardiopulmonary resucitation efforts is dependent on the commonly used methods, such as the presence of femoral or carotid artery pulsations, arterial blood gas determinations, peripheral arterial pressure and intracardiac pressure monitoring. But recent studies suggest that end-tidal carbon dioxide tension serves as a non-invasive measurement of pulmonary blood flow and therefore cardiac output under constant ventilation. A prospective clinical study was done to determine whether end-tidal carbon dioxide monitoring in open heart surgery under cardiopulmonary bypass could be used as a prognostic indicator of bypass weaning. We monitored end-tidal PCO2 values continuously during cardiopulmonary bypass in 30 patients. "Ohmeda 5210 CO-2 monitor" under infrared absorption method were incorperated into the ventilator circuit by means of a side point adaptor between endotracheal tube and ventilator tubing. 18 patients[Group I ] were res-ucitated from partial bypass followed by aorta cross clamp off and 12 patients[Group II ] from aorta cross clamp off followed by partial bypass. But there was no difference between two groups[p>0.05]. The value of end-tidal carbon dioxide tension during ventricular fibrillation or nearly arrest state was 6.6$\pm$2.9 mmHg, and at the time of spontaneous beating was 19.3$\pm$5.6 mmHg[Mean$\pm$Standard deviation], In conclusion end-tidal carbon dioxide tension monitoring provides clinically useful, continous, noninvasive and supplementary prognostic indicator during cardiopulmonary bypass weaning procedures.rocedures.