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정태은,한승세 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery Vol.31 No.11
Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.
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정태은 영남대학교 의과대학 1996 Journal of Yeungnam Medical Science Vol.13 No.2
허혈성 심질환의 치료로서 시행되는 관동맥 우회술은 최근 국내에서도 보편적으로 시행되고 있는데 1992년부터 1996까지의 영남대학교 의과대학 흉부외과학교실에서 시행한 63례의 관동맥 우회술을 대상으로 수술성적 및 술전 위험인자들이 술 후 합병증에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 환자의 성별 및 연령을 보면 총63례의 환자 중 남자가 44례, 여자가 19례였으며 연령분포는 36세에서 71세까지 평균 58.3±8.6세 였으며 50대와 60대에서 대부분을 차지하였다 원위문합수는 환자당 평균 3.5개의 원위부 문합을 하였으며 수술사망은 6례였으며 술후 합병증으로 부정맥이 7례, 창상감염이 5례, 술후 출혈이 4례, 술중 및 술후 심근경색이 4례, 뇌졸증이 4례, 그리고 위장관 및 신장 합병증이 5례에서 발생하였다. 술후 합병증 발생의 요소를 분석 해 본 결과 술전 관동맥 질환 발생의 위험인자 중 흡연환자에서 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 술전 위험인자로 정맥으로 Nitroglycerin의 투여가 필요했던 경우와 대동맥 차단시간이 2시간 이상인 경우에 경우 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 특히 65세 이상의 고령환자의 경우 수술사망율이 유의하게 증가하였다(p<0.05). 이상의 결과로 흡연, 65세 이상의 고령, 술전 정맥으로 Nitrogloycerin의 투여가 필요했던 경우 그리고 이식혈관의 수가 많아 대동맥 차단시간이 긴 경우 술중 및 술후 관리에 더욱 섬세한 주의가 필요함을 알 수 있었다. From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp time(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.
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체외순환 없이 시행한 관동맥우회술 후 발생한 척추신경경색
정태은,이동협,권진태,안상호 대한흉부외과학회 2006 Journal of Chest Surgery Vol.39 No.7
고혈압과 고지혈증 그리고 허혈성심질환을 가진 62세 여자 환자가 심폐기를 이용하지 않는 관동맥우회술을 시행한 뒤 척추신경경색이 발생하였다. 심폐기를 이용하지 않는 관동맥우회술을 시행하는 경우 신경계 합병증의 발생 빈도는 통상의 관동맥우회술보다 낮다고 알려져 있다. 특히 관동맥우회술 후 척추신경경색의 발생은 매우 드물다. 심폐기를 이용하지 않는 관동맥우회술을 시행한 후 척추신경경색이 발생한 1예를 문헌 고찰과 함께 보고하는 바이다.
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鄭太銀,金世景 고려대학교 의과대학 1979 고려대 의대 잡지 Vol.16 No.3
Fifty cases of kidney pelvic stone were admitted to the Department of Urology, Korea University Medical College during the period from Jan. 1968 to Dec. 1977 for the surgical removal of stone. The age of patient ranged from 6 to 54 and 38 cases were male and 12 cases were female. A new technique of pyelolithotomy was performed with incision made over the lower portion of renal pelvis as shown in Fig. 3 through the extraperitoneal subcostal arcuate anterolateral kidney approach with semilateral position and the following results were obtained. 1. In all fifty cases kidney pelvic stones were not spherica1 but flat in shape, and their removal were easily performed through the incision made over the lower portion of the renal pelvises. 2. Anatomically, very few distribution of the blood vessels were found in the lower area of the kidney pelvis and the maniplaotin for removal of the stone was easier than that of other area of the kidney pelvis. 3. During the manipulation of stone removal damages of the renal parenchyma or mucosal damages in the kidney pelvis if any could be kept at a minimum. 4. When the kidney was eqosed by extraperitoneal subcostal arcuate antero-lateral approach, the exposure of the lower portion of the hilum and the area of the kidney pelvis was easily made by mobilization and retraction of the kidney lower pole to the lateral side and this technique was found to be very convenient in removal of most kidney pelvic stones.
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鄭太銀 우석대학교 의과대학 1971 우석의대잡지 Vol.8 No.1
In spite of highly developed antibiotics and chemotherapeutics, genitourinary tract infection still remaines as troublesome subjects for urologists. New bactericidal agent, Bactrim (trimethoprim-sulfamethoxazole) was administered in 18 cases of genitourinary tract infection, which were resistant to mast antibiotics and following results were obtained. 1) Among 9 cases of non-gonococcal urethritis, 5 cases were cured completely, 4 cases were improved. 2) Among 7 cases of chronic prostatitis, one case was cured but only mild improvement were noted in remaining 6 cases. 3) 2 cases of pyelonephritis showed improvement in both clinically and bacteriologically.
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정태은,신효철 대한기계학회 1993 대한기계학회논문집 Vol.17 No.10
Thermal deformations and stresses due to temperature changes are the serious problems in cryogenic structures such as the torque tube in a superconducting generator, In this paper, the equations of thermal expansion coefficients expressed only by material properties and winding angles are derived for the filament wound composite tubes. The experimental results of thermal contraction of CFRP tubes are compared with those from theoretical approach. Composite tubes with optimally regulated thermal expansion coefficient are designed on the basis of the study for the torque tube in the superconducting generator with temperature distributions varying from 300K to 4.2 K. The filament winding angle of composites resisting thermal stresses properly is sought by the finite element method using layered shell elements. The results show that the composite tubes designed for the requirements in cryogenic environments can effectively cope with the thermal stress problem.
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