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Pure esophageal atresia. 2 case
정상석,최필조,박권재,방정희,조광조,우종수,정진아,Jeong, Sang-Seok,Choi, Phil-Jo,Park, Kwon-Jae,Bang, Jung-Hee,Cho, Gwang-Jo,Woo, Jong-Soo,Jung, Jin-A 대한기관식도과학회 2008 大韓氣管食道科學會誌 Vol.14 No.1
Pure esophageal atresia without tracheoesophageal fistula is a uncommon form of congenital malformation of the esophagus, which is able to be suspected by fetal ultrasonograpy before delivery and diagnosed definitely by simple chest X-ray and esophagogram immidiately after delivery. We performed delayed primary repair in 2 cases of pure esophageal atresia by using stomach for conduit in one case and colon in the other case. But there were graft failure in the latter case, so reoperation was performed by using stomach. Postoperatively, two patients showed no stenosis and leakage in anastomotic site and were discharged in good oral intake without dysphagia.
식도암 환자에서 da Vinci 로봇을 이용한 식도암 수술 (흉골하 통로를 통한 식도-위 문합술) −1예 보고−
정상석,최필조,우종수,김시호,방정희,박권재 대한흉부외과학회 2009 Journal of Chest Surgery (J Chest Surg) Vol.42 No.3
Operations using the da Vinci robot have performed in for many surgeries, but the adoption of robotics to general thoracic surgery has been slow. The patient (age 74, male) visited our hospital complaining of hiccups and dysphagia. The CT scan and endoscopic biopsy revealed esophageal cancer (squamous cell carcinoma). We performed transthoracic esophagectomy using a da Vinci robot and this was followed by gastric tube mobilization via laparoscopy. Cervical esophago-gastric anastomosis was done using the hand-sewn method. The gastric tube was brought into the neck through the retrosternal route. The patient was discharged without any complications. We report here on a case of successful da Vinci robotic esophgagectomy. 다빈치 로봇수술은 현재 다양한 외과영역에서 시행되고 있으나 폐, 식도 외과영역에서는 아직까지 널리 이용되지 않고 있다. 본원에서는 74세 남자환자가 딸꾹질과 연하곤란을 주소로 내원하여 시행한 검사에서 식도암으로 진단되어 da Vinci 로봇을 이용하여 식도절제술을 시행한 후, 복강경으로 위장튜브를 만들어 흉골하 통로를 통해 경부에서 위장-식도 단단 문합을 시행하였다. 환자는 수술 후 특별한 합병증 없이 완쾌 퇴원하였다. 향후 다빈치로봇을 이용한 최소 침습수술이 식도암을 비롯한 폐, 식도외과 영역에의 활용에 있어서 좋은 결과가 기대되므로 보고하는 바이다.
Bochdalek hernia presenting gastrointestinal symptoms in late childhood: a case report
정상석 고신대학교(의대) 고신대학교 의과대학 학술지 2023 고신대학교 의과대학 학술지 Vol.38 No.1
Most cases of congenital diaphragmatic hernia (CDH) can be diagnosed based on symptoms of severe respiratory failure during the neonatal period or fetal ultrasonography. However, some rare cases are diagnosed in late childhood or adolescence. In this case report, I describe an 11-year-old male patient diagnosed with late-onset CDH presenting with acute abdominal pain. The patient had recently experienced anorexia, nausea, and vomiting after eating. However, he reported no abdominal pain or past history of trauma. The abdomen was generally convex. All laboratory data were within normal limits. A chest X-ray revealed elevation of the left diaphragm. Chest computed tomography showed a defect in the left diaphragm. Based on the above radiologic findings, emergency surgery was performed after the diagnosis of diaphragmatic hernia. A surgical incision was performed in the left subcostal area. Finally, late-presenting Bochdalek hernia was diagnosed. The operation was completed and no specific findings on chest X-ray were found after surgery. The patient was discharged on the fourth day after surgery. In conclusion, CDH in late childhood or adolescence is rare and has various clinical manifestations. To avoid complications such as strangulation and bowel perforation, emergency surgery may be required. Thus, it is necessary to suspect CDH in children with recurrent gastrointestinal or respiratory symptoms, based on which an accurate diagnosis can be made and successful surgical treatment can be performed.
정상석,최필조,이정훈,윤성실 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.2
Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.
듀얼 모드 위상 시프트 ZVS PWM 제어 고주파 공진형 인버터를 이용한 IH 온수기
정상석,유의정(Yeoi-Joung Ryu),우경일(Kyung-Il Woo),박한석(Han-Seok Park),Sang-Wook Lee 대한전기학회 2018 전기학회논문지 P Vol.67 No.2
This paper presents a novel prototype of dual mode control based phase shift ZVS PWM high frequency load resonant inverter with lossless snubber capacitors in addition to a single active auxiliary resonant snubber for electromagnetic induction heating(IH) foam metal based consumer fluid dual packs(DPA) heater. The operating principle in steady state and unique features of this voltage source soft switching high frequency inverter circuit topology are described in this paper. The lossless snubber and auxiliary active resonant snubber assisted constant frequency phase shift ZVS PWM high frequency load resonant inverter employing IGBT power modules actually is capable of achieving zero voltage soft commutation over a widely specified power regulation range from full power to low power. The steady state operating performances of this dual mode phase shift PWM series load resonant high frequency inverter are evaluated and discussed on the basis of simulation and experimental results for induction heated foam metal heater which is designed for compact and high efficient moving fluid heating appliance in the consumer pipeline systems.