객혈환자의 흉부외과적 고찰

이형렬,정황규,Lee, Hyeong-Ryeol,Jeong, Hwang-Gyu 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.1

The Hippocratic aphorism, "the spitting of pur follows the spitting of blood, consumption follows the spitting of this, and death follows consumption," gives ancient documentation to the significance of hemoptysis in the intrathoracic disease. Hemoptysis is still one of the most alarming and startling of all symptoms. For most patients and not a few doctors, the expectoration of blood signals either pulmonary tuberculosis or cancer. But with the advent of modern thoracic surgical methods, differential diagnosis has become doubly important and appropriate treatment has provided the patients with full recovery or improvement of hemoptysis. Author reviewed 72 cases of patients with a chief complaint of hemoptysis, who were performed open thoracotomies in the Dept. of Thoracic and Cardiovascular Surgery, Pusan National University Hospital for 5 years from April 1980 to March 1985. The results were as follows: 1. The mean age of hemoptysis patients was 35.1 year old with a range from 16 to 64, and hemoptysis was most prevalent in the twenties and male dominant. 2. The most common underlying lung disease of hemoptysis was bronchiectasis [37.5%]. 3. The monthly peak frequency of hemoptysis was in the February [25.[%]. 4. Left lower lobe was the most common site of developing hemoptysis. 5. Lobectomy was the most frequent operative method of all open thoracotomies. 6. The hemoptysis caused by lung cancer recurred most frequently [21.4%], and the prognosis of operation was desperate. 7. The common postoperative complications of hemoptysis patient were re-hemoptysis [24%], bleeding [20%], and atelectasis [16%], and immediate postoperative mortality rate was 2.8%. was 2.8%.

후천성 삼첨판폐쇄부전증의 외과적 치료에 대한 연구

이형렬,김종원,Lee, Hyeong-Ryeol,Kim, Jong-Won 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.3

Fourty-five cases of operation were performed for the correction of tricuspid regurgitation [TR] in Pusan National University Hospital between 1982 and 1991.The mean age of the patients was 32.6 years and female was dominant[M:F=1:2.2].Isolated tricuspid regurgitation was rare and 43 patients underwent concomitant other valvular operation including mitral valve replacement. Functional cause was in 39 cases and organic lesions were found in 6 cases. Operative methods were Kay annuloplasty[29], De Vega annuloplasty[12], and tricuspid valve replacement[4]. Ring annuloplasty was not performed. Operative mortality rate was 11.1%[5/45] and late mortality rate was 6.7%[2/30]. The tricuspid valve surgery itself was not a serious risk factor for hospital death and no heart block nor thrombosis was complicated. By echocardiogram early[within 30 days] and late [mean:4.9years] changes of postoperative TR were evaluated. De Vega annuloplasty seemed to bring better late result than Kay annuloplasty[p<0.05]. In four patients with late severe TR,previously replaced tissue valve degeneration[2], pulmonary hypertension[1] and rheumatic TR[1] were the possible causes. This experience suggests that De Vega annuloplasty can be a reliable method in the majority of patients with moderate-to-severe functional TR.

최적파괴확률에 의한 농업시설물의 단면설정

이형렬 ( Hyeong Ryeol Lee ),전정배 ( Jeong Bae Jeon ),윤성수 ( Seong Soo Yoon ) 한국농공학회 2013 한국농공학회 학술대회초록집 Vol.2013 No.-

농업생산에 있어 기후는 생산량에 중요한 영향을 끼치는 인자이다. 전 지구에서의 기후변화는 우리나라의 농업 환경에 많은 영향을 주고 있을 뿐만 아니라 과거의 기상을 토대로 설계된 농업생산기반 시설에도 큰 영향을 주고 있다. 특히 온실은 풍속과 적설심에 많은 영향을 받는 구조물로서, 구조 안전성을 확보하기 위해서는 구조형태와 단면형상 및 크기에 따라 적합한 안전풍속과 안전적설심을 확보해야 한다. 구조 설계과정에서 재료의 물성치, 하중, 치수공차 등의 각종 설계변수들은 불확실성(uncertainty)을 갖게되며 기존결정론적 설계방법에서는 이들을 확정값(평균)으로 가정하여 설계를 수행하여왔다. 그 결과 설계변수들의 불확실성이 목적함수나 제약조건에 미치는 영향이 무시되어 최적설계 결과가 제약조건을 만족시킬 확률이 감소한다. 기존 온실에 대한 안정성 검토 및 설계는 연구자들에 의하여 지속적으로 연구되어 왔으나 결정론적 구조해석 방법을 주로 사용하여 왔다. 결정론적 구조해석 방법과 다르게 확률론에 기초한 신뢰성 해석기법은 불확실성을 정량적으로 취급하여 구조물의 안전성을 확보하는데 보다 합리적인 수단이 될 수 있다. 또한 구조시스템의 파괴나 안전성의 결여는 일정한 안전율을 가지는 조건에서도 재료나 하중의 통계적인 특성의 차이에 따라 달라지기 때문에 구조설계시 신뢰성해석이나 설계이론을 적용한 설계법을 도입할 필요가 있다. 본 연구에서는 농업생산기반 구조물인 유리온실 중 한국형 유리온실 표준설계도를 대상으로 신뢰성 해석 기법 중 하나인 몬테카를로 시뮬레이션을 이용하여 각 부재별 파괴확률 산정하였고, 파괴확률 산출 결과를 토대로 최적 단면설정을 실시하였다.

AHP-GIS를 이용한 귀농 · 귀촌 최적 입지 분석

이형렬(Lee, Hyeong-Ryeol),전정배(Jeon, Jeong-Bae),윤성수(Yoon, Seong-Soo) 한국지역사회생활과학회 2013 한국지역사회생활과학회 학술대회 자료집 Vol.2013 No.4

농지 규모화에 따른 오염물질의 최소 배출 농작업 기계 최적 조합 모델

이형렬 ( Hyeong Ryeol Lee ),윤성수 ( Seong Soo Yoon ),전정배 ( Jeong Bae Jeon ),박진선 ( Jin Seon Park ) 한국농공학회 2012 한국농공학회 학술대회초록집 Vol.2012 No.-

농작물 생산에 있어 농지의 대규모화와 농기계의 적극적 활용에 따라 농작물의 생산에 있어서도 대기오염물질의 방출은 불가피한 실정이다. 기존에 사용되고 있는 대중교통 및 대형 차량 등에 대해서는 전과정 평가를 기반으로 한 오염물질 배출의 정량적 평가에 대한 노력이 있었지만, 농기계에 대해서는 정성적 평가의 한계를 크게 넘지 못하고 있는 수준이다. 그러나 농작물 생산을 위한 농기계의 사용이 보편적으로 자리 잡고 있어 시기별 농기계 사용에 대한 온실가스 및 오염물질 배출량에 대한 정량적 산출을 전과정 평가의 관점에서 살펴 볼 필요가 있다. 또한 시기별로 사용되는 장비의 조합은 최종 사용자인 농민이 선택할 수 있는 여지가 있는 부분이므로 같은 효율을 발휘한다는 가정 하에 최소오염물질 방출량을 나타낼 수 있는 최적 사용 장비의 조합을 도출할 필요가 있다. 따라서 본 연구에서는 연중 농작업 시기별로 사용되는 농기계의 온실가스 및 오염물질 방출량을 산출하고, 농작물 생산에 필요한 최소 오염물질 방출을 나타내는 장비의 최적 조합을 도출하는 것을 목적으로 한다. 연구의 범위 및 방법은 수도작 1ha를 경작할 때 시기별로 사용되는 기계의 오염물질 방출량을 조사하고, 조사된 자료를 이용하여 Lingo™을 이용하여 장비의 최적 조합을 찾아내고자 하였다.

대동맥 장골동맥 폐쇄성 질환에서 혈관 우회술의 임상적 고찰

정성운,이형렬,김종원,Jeong, Seong-Un,Lee, Hyeong-Ryeol,Kim, Jong-Won 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.10

Between Jan.1990 and Mar.1994, twenty-three patients[Male:20, Female:3 with aortoilac occlusive disease had underwent reconstruction [bypass garft . Two main causes of occlusion were atherosclerosis [21 patients and chronic thromboembolism[2 patients . Indications for operation were disabling claudication in 20 patients and critical limb ischemia in 12 patients. The procedures of operation included femorofemoral[8 , axillobifemoral[6 , aorto-bifemoral[6 , axillounifemoral[2 , aortoiliac[1 bypass graft. Postoperatively one patient died for sepsis and the operative mortality was 4.3%. Various anticoagulant therapy were maintained for at least six months. The 1year, 2year, 3year and 4year patency rates of bypass graft after operation were 91.3%, 80.8%, 71.4% and 58.4% respectively.

식도 천공의 보존적 치료 - 임상적 고찰 14례

배병우,이형렬,김종원,Bae, Byeong-U,Lee, Hyeong-Ryeol,Kim, Jong-Won 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.8

Twenty-five patients with perforation of esophagus were managed at Pusan National University Hospital, from 1981 to 1993. The hospital course of 14 of these patients was evaluated with a special emphasis on the cause and location of perforation, clinical presentation, time elapsed from perforation to treatment, method of treatment, and outcome. Patients with anastomotic leak and cancer were excluded.The perforation was iatrogenic in 7 patients, spontaneous in 5, ingestion of foreign body in 1, and traumatic in 1. There were 7 cervical perforations, 2 upper thoracic perforations, and 5 lower thoracic perforations. Chest pain, fever, and dyspnea were frequent symptoms. Esophagography was most diagnostic [11 patients] but thoracentesis was of little diagnostic aid.Antibiotics were administered intravenously to all patients:hyperalimentation was accomplished intravenously in 11, and nasogastric suction was used in all cases. No patient required any surgical procedure, minor or major.

외엽형 폐격리증을 동반한 선천성 낭종성 선종양 기형 -1례 보고-

전상협,김병준,이형렬,Jeon, Sang-Hyeop,Kim, Byeong-Jun,Lee, Hyeong-Ryeol 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.2

Pulmonary sequestration and congenital cystic adenomatoid malformation are two infrequent congenital pulmonary diseases and the combination of these two entities is rare. We had experienced a 3 week old male patient with a pulmonary mass, who had been sufyerring from tachypnea and chest wall retraction after birth. The pulmonary mass was suspected as a congenital cystic adenomat id malformation by chest CT. And therefore, we performed urgent operation via standard thoracotomy incision. Upon a thoracotomy, there was an extrapleural mass with anomalous blood supply near the posterior diaphragm and multiple cystic lesions in right lower lobe. The two anomalous arteries arising from the thoracic aorta and one vein draining into the azygos vein were ligated. and then the extrapleural mass was removed and a right lower lobectomy was performed. Final histologic diagnosis was congenital cystic adenomatoid malformation associated with extralobar pulmonary sequestration. The patient was discharged without any problem. 선천성 낭종양 선종양 기형과 외엽형 폐격리증은 각각드문 질환으로 이 두가지 질환이 퐁반되는 경우는 매우 드물다 본원에서는 출생 후 호흡시 흥벽 함몰과 빈호흡을 보인 생후 3주된 남아에서 컴퓨터 단층촬영을 통해 우폐하엽의 선천성 낭종성 선종양기형을의심하여 개흥술을시행하였다. 수술소견상 우폐하엽의 낭종성 병변 이외에 독립된 늑막에 둘러싸인채 비정상적인 혈류 공급을 받고 있는 종괴를 발견하여 하행 흉부 대동맥으로 부터 공급되는 2개의 동맥 가지와기정맥으로 유입되는 정맥분지를 결찰한 후 우하엽절제술과 더불어 격리폐를 절제하였다. 병리검사로 상기 두질환의 동반례로확진 하였고 환자는 건강한 모습으로 퇴원할 수 있었다.

식도의 기저세포양 펀평세포암 -1례 보고-

박서완,정성운,이형렬,Park, Seo-Wan,Jeong, Seong-Un,Lee, Hyeong-Ryeol 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.9

기저세포양 편평세포암(basaloid squamous carcinoma)은 상부 기도소화기계에 발생하는 드문, 악성도가 높은 암종으로 침습성 편평세포암(invasive squamous carcinoma)이나 상피내암(carcinoma in situ) 형태의 편평상피암종성분과 밀접하게 혼재되어 있는 기저세포앞종성분(basaloid component)으로 특징 지워질 수 있다. 이런 조직학적 특성에도 불구하고 식도의 선양 낭성암(adenoid cystic carcinoma)이나 선양 낭성 분화를 보이는 암종(carcinoma with adenoid cystic differentiation)과 혼동되어 왔으나, 순수 선양 낭성암은 악성도가 기저세포양 편평세포암보다 낮아감별 진단이 중요하다. 기저세포양편평세포암의 임상적 경과는 식도의 편평세포암과 유사하다. 본 병원에서는 60세 남자의 식도 중간 113 부위에 발생한 기저세포양 편굉세포암을 수술치험하였다. Basalold squamous carcinoma (BSC) is a rare, aggressive neoplasm of the upper aerodigestive tract or esophagus. It is characterized by a biphasic pattern in which basaloid tumor is intimately associated with a neoplastic squamous component which can be either Invasive r in situ. Despite its characteristic histologic appearance, the BSC of the esophagus has been confused with esophageal neoplasm variously reported as adenoid cystic carcinoma or carcinoma with adenoid cystic differentiation Their distinction is important because genuine adenoid cystic carcinoma is much less as- gressive than BSC. The biologic course of BSC is similar to that of the more frequent squamous cell carcinoma of the esophagus. We have experienced a case of BSC of the esophagus in a 60-year-old male patient. The lesion was located in the middle third of the esophagus. The patient was treated with surgery followed by radio- therapy.

경계요소법을 이용한 평면변형율요소의 확률해석

전정배,윤성수,박진선,이형렬,Jeon, Jeong-Bae,Yoon, Seong-Soo,Park, Jin-Seon,Lee, Hyeong-Ryeol 한국농공학회 2012 한국농공학회논문집 Vol.54 No.4

The objectives of this study is intended to analyze stresses using the boundary element method and probability analysis for agricultural structure. Loads and material properties are an important factor when analyzing the structure. Until now, designing structure, loads and material properties are applied deterministic value. However, load and material properties involve uncertainties due to those change probabilistic and deterministic methods could not consider uncertainties. To solve these problems, the reliability analysis based on probability properties scheme was developed. Reliability analysis is easy to approach to analysis frame structure, however it has limitation when solving plane stress strain problems a kind of agricultural structures. The BEM (Boundary Element Method) is able to analysis plane strain problems by boundary conditions. Thus, this study applied boundary element method to analysis plane strain problem, load and material properties as a probabilistic value to calculate the analytical model using Monte Carlo simulations were developed.