변형 Fontan 술식을 이용한 선천성 심기형증 치험 2

민용일,안병희,이동준,Min, Yong-Il,An, Byeong-Hui,Lee, Dong-Jun 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.3

Recently, direct atriopulmonary anastomosis was performed in 2 patients without using pericardium or prosthetic material. Case 1 A 13-year-old male patient whose diagnosis was tricuspid atresia [type lb] received direct atriopulmonary anastomosis successfully with good clinical and hemodynamic results. Nine months after operation, he has an increased exercise tolerance. Case 2 A 4-year-old female patient whose diagnosis was DORV with pulmonary atresia in A-V discordance had a formidable surgical challenge. A large-diameter direct atriopulmonary anastomosis was performed after the closure of the right atrioventricular valve. Her postoperative course has been even in 20th postoperative day.

인태아 폐의 신경상피소체와 신경종말에 관한 미세구조적 연구

민용일,윤재룡,Min, Yong-Il,Yoon, Jae-Rhyong 한국현미경학회 1995 Applied microscopy Vol.25 No.1

Ultrastructure of nerves and their associated cells in the bronchiolar epithelium of the human fetal lung were studied with ultrastructural and immunohistochemical methods. The neuroendocrine cells were scattered along the basal part of non-ciliated respiratory epithelium and appeared as single cell (solitary neuroendocrine cell) or groups (neuroepithelial bodies). The solitary neuroendocrine cells were devoid of any detectable innervation, while the neuroepithelial bodies were associated with nerve ending containing morphologically afferent (sensory) and efferent (motor) intraepithelial terminals. The afferent nerve endings contained abundant mitochondria with long cristae. The efferent nerve endings were characterized by the presence of synaptic vesicles. Both types of nerve endings formed synaptic junction between nerve endings and neuroepithelial bodies cells. Serial sections of the intraepithelial nerves revealed that both morphologically afferent and efferent types of nerve endings may be formed by the same nerve fiber. By immunohistochemistry, bombesin and serotonin were localized in solitary neuroendocrine cells and neuroepithelial bodies of human fetal lung from various prenatal age groups. These results suggest that the neuroepithelial bodies cells of the human fetal lung have neuroreceptor function.

Fallot 4징증의 근치수술후 예후에 영향을 미치는 요소

민용일,오봉석,이동준,Min, Yong-Il,O, Bong-Seok,Lee, Dong-Jun 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.1

Twenty six patients were operated a total correction of tetralogy of Fallot between Jan., 1984 and July, 1985 at the Dept. of thoracic and cardiovascular surgery, Chonnam University Medical School, and a comparison between the survived group [n = 18] and the dead group [n = B was performed to detect factors influencing laboratory data, cineangiographic findings, operative findings and methods, and pump time. Following results were obtained, 1. There was no significant difference between two groups in the preoperative P.O2 and hematocrit level. 2. The size of the interventricular defect was not related to the operative mortality. 3. There was a significant difference in mortality rate between combined type of stenosis of pulmonary artery, valve and infundibulum and other types of right ventricular outflow tract stenosis. 4. There was a significant difference in mortality rate between the transannular patch reconstruction and other types of operative procedure. 5. There was no significant difference between two groups in total bypass time and aortic time. 6. There was no significant difference between two groups in left ventricular end diastolic volume and right ventricular end diastolic volume. 7. The operative mortality was related to the ratio of the diameter of the pulmonary valve annulus or each pulmonary artery to the ascending or descending aorta in cineangiographic findings, but there was no statistical significance of which probably is due to the lack of the total number of patients.

최근 1년간 응급실 내원환자 21,700명에 대한 임상적 분석

민용일 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2

21,700 cases of patients who visited Department of Emergency Medicine in Chonam University Hospital from August 1, 1993 to July 31, 1994 were reviewed. The results were as follows : 1. In 21,700 total visits(average 59.5 in a day), male to female ratio was 1.47 : 1 and the peak age group was 3rd decade(16.3% of total visit). 2. Disease to injury ratio was 2.1 : 1. In disease, male to female ratio was 1.2 : 1. A male predominece was found among injury as 2.2 : 1, respectively. The major groups of disease were children younger than 10 years of age and adults older than 50 years. In contrast, 42.3% of total injuries occured in 3rd and 4th decades. 3. The ratio of self-visit to transfer from other hospitals was 3 : 1, The majority(83.3%) used non-emergency vehicle such as taxi or bus. In contrast, the use of rescue services or ambulances were extremely rare. 4. The visiting patients were composed of internal medicine as 24.6%, pediatrics as 12.6%, surgery as 36.1%, and emergency medicine as 21.7%. The disposition was composed of discharge as 60.5%, admission to ward as 29.5%, and transfer to other hospital as 6.5%. 5. Averaged transit time in emergency room was 18.5 hours ; 31.3 hours for admission to ward, 14.0 hours for discharge, and 7.8 hours for transfer to other hospital, respectively. 6. Monthly visit was relatively even. Visits increased slightly on April, May, June, July, and October. 7. In daily visit, it increased slightly on Saturday and Sunday. 8. The majority of patients visited to emergency room between noon and midnight. In contrast, visits decreased abruptly form 1 : 00 AM. 9. The number of DOA was 320. In addition, the number of DAA and hopeless discharge was 644. Thus, mortality rate was 3.0%.

PROLOGUE (PROgnostication using LOGistic regression model for Unselected cardiac arrest patients in the Early stages): A scoring system for early prognostication in unselected adult cardiac arrest patients

민용일,배대희,이형연,정용훈,정경운,이병국,윤준성,허탁 대한응급의학회 2020 대한응급의학회 학술대회초록집 Vol.2020 No.2

Introduction We aimed to develop a scoring model for early prognostication in unselected adult CA patients. Material & Method We retrospectively analysed data of adult non-traumatic CA patients treated at a tertiary hospital between 2014 and 2018. Primary outcome was poor outcome at hospital discharge (CPC 3-5). Using multivariate logistic regression analysis, independent predictors were identified among known outcome predictors, that were available at ICU admission, in patients admitted in the first 3 years (derivation set), and a scoring system was developed with the variables retained in the final model. The scoring model was validated internally using the leave-one-out cross-validation and externally in patients admitted in the last 2 years (validation set). Result Age, witnessed collapse, shockable rhythm, adrenaline dose, CPR duration, light reflex, GCS motor score, and levels of creatinine, potassium, phosphate, haemoglobin, and lactate were retained in the final model and used to develop the scoring system. Our model performed excellently in the derivation set, internal validation, and validation set (AUC of 0.940, 0.930, and 0.942; Hosmer-Lemeshow P = 0.594, 0.311, and 0.392). Conclusion We developed a scoring model for early prognostication in unselected adult CA patients. Further external validation is needed.

Relationship between common target variables for brain tissue oxygen tension-guided care and brain tissue oxygen tension in condition without hypoxemia or hypotension after cardiac arrest

민용일,허탁,정용훈,( Kamoljon Shamsiev ),정경운,( Najmiddin Mamadjonov ),이형연,이병국,강병수 대한응급의학회 2020 대한응급의학회 학술대회초록집 Vol.2020 No.2

Introduction Brain tissue oxygen tension (PbtO2)-guided care, which is a therapeutic strategy to treat or prevent cerebral hypoxia through modifying determinants of cerebral oxygen delivery including arterial oxygen tension (PaO2), end-tidal carbon dioxide (ETCO2), and mean arterial pressure (MAP), has recently been introduced. Studies reported that cerebral hypoxia occurred after cardiac arrest in the absence of hypoxemia or hypotension. To obtain preliminary information on the degree to which the PbtO2 is responsive to changes in the common target variables for PbtO2-guided care in this setting, we investigated the relationships between the common target variables for PbtO2-guided care and PbtO2 using data from an experimental study in which the animals did not experience hypoxemia or hypotension after resuscitation. Material & Method We retrospectively analyzed 170 sets of MAP, ETCO2, PaO2, and cerebral microcirculation parameters obtained during the 60-min post-resuscitation period in 10 pigs resuscitated from ventricular fibrillation cardiac arrest. The PbtO2 and cerebral microcirculation parameters were measured on parietal cortices exposed through burr holes. Multiple linear mixed effect models were used to test the independent effects of each variables on PbtO2. Result PbtO2 progressively decreased during the 60 min post-resuscitation period (Figure 1). Despite the absence of arterial hypoxemia or hypotension, 7 animals (70%) experienced cerebral hypoxia (defined as a PbtO2 below 20 mmHg). Linear mixed effect models revealed that neither the MAP nor the ETCO2 was related to the PbtO2 (Table 1). PaO2 had a significant linear relationship with PbtO2 after adjustment for significant covariates (P = 0.030), but it could explain only 17.5% of the total variance of PbtO2 (semi-partial R2 = 0.175; 95% confidence interval, 0.086- 0.282). Conclusion In conclusion, MAP and ETCO2 were not significantly related to the PbtO2 in the data from animals without hypoxemia or hypotension during the early post-resuscitation period. PaO2 had a significant linear association with the PbtO2, but its ability to explain the variance of PbtO2 was small.

개심술 500례의 임상적 고찰

민용일 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.1

From May 1977 to June 1986, 500 cases of open heart surgery were performed under the cardiopulmonary bypass. There were 278 male and 222 female patients ranging from 6 months to 69 years. 363 cases[73.6%] were congenital heart diseases, and 137 cases[27.4%] were acquired heart diseases, which were 33 valvular diseases, 3 myxomas and 1 IVC obstruction. There were 363 congenital heart anomaly with 35 operative deaths[9.6%], consisting of 279 acyanotic cases with 12 deaths [4.3%] and 85 cases of cyanotic cases with 23 deaths[28.4%]. In 133 patients of acquired valvular disease, 124 valves were implanted and operative death of valvular disease was 12%. Finally the operative mortality was 9.6% in congenital anomaly, and 12.4% in acquired heart disease, overall mortality rate was 10.4%.

심장판막증의 외과적 치료

민용일,김상형,이동준,Min, Yong-Il,Kim, Sang-Hyeong,Lee, Dong-Jun 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.3

From September 1980 to July 1986, 135 cases of cardiac valve surgery were performed under the cardiopulmonary bypass. Out of 135 cases, single valve surgery was 114 cases including open mitral commissurotomy 17, mitral annuloplasty 2, mitral valve replacement 85, and aortic valve replacement 10 and double valve surgery was 21 cases. There were 68 males and 67 females ranging from 9 to 57 years of age. Early death within 30 days after operation was 17 cases [12.6%] and caused of death were ventricular arrhythmia 5, low cardiac output syndrome 4, excessive bleeding 3, pulmonary complication 2, and so on. Among 118 early survivors, 5 cases [5.1%] of late death were developed over a period of 2 to 72 months, and main cause of death was fatal bleeding complication associated with anticoagulation therapy. Symptomatically, 91.8% of patients were in NYHA functional class I or II at the end of the follow-up.

A Parallel Algorithm for Merging Heaps on MasPar Machine

민용식,Min, Yong-Sik 한국정보처리학회 1995 정보처리논문지 Vol.2 No.4

본 논문은 크기가 n와 k인 nheap과 kheap을 병합시키기 위한 병렬 알고리즘을 제 시함과 동시에 그들을 MasPar상에 실제로 구현하고자 하는데 그 주된 목적이 있다. 이때, EREW-PRAM(Exclusive-Read Exclusive-Write Parallel Random Acess Machin)상에 서 max(2$^{-1}$, $\ulcorner$(m+1)/4$\lrcorner$개의 프로세서를 이용해서 본 논문에 제시된 알고리즘 의 시간 복잡도가 O(log(n/k)*log(n))임을 제시하였다. 여기서 i는 heap의 height를 뜻하며, m은 크기 n과 k의 합으로 구성된 것이다. 또한 이것을 MasPar 컴퓨터에 적용 을 시켰을 때, 테이타의 양이 8백만개이고, 64개의 프로세서를 이용한 경우의 speedup 을 33.934를 얻었다. 이때 적용된 데이타의 형태는 불완전 힙상에서 크기가 k〈n를 지 니는 경우의 처리이다. 그리고 이같이 제시된 알고리즘의 EPU(Effective Processor Utilization)을 계산하면 1인 최적의 speedup율을 나타냄을 알 수가 있다. In this paper, we suggest a parallel algorithm to merge priority queues organized in two heaps, kheap and nheap of sizes k and n, correspondingly. Employing max(2$^{-1}$, $\ulcorner$(m+1)/4$\lrcorner$'s processors, this algorithm requires O(log(n/k)*log(n)) on an EREW-PRAM, where i is the height of the heap and m is the summation of sizes n and k. Also, when we run it on the MasPar machine, this method achieves a 33.934-fold speedup with 64 processors to merge 8 million data items which consist of two heaps of different sizes. So our parallel algorithm's EPU is close to 1, which is considered as an optimal speedup ratio.eedup ratio.

전신성 지방이영양증 1예

민용기,조보연,이홍규,고창순,민헌기,이문규,김용성,김성연 대한내분비학회 1989 Endocrinology and metabolism Vol.4 No.3