폐결핵(肺結核)의 외과적(外科的) 요법(療法)

홍장수,서경필,Hong, Chang Soo,Suh, Kyung Phill 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

The author reviewed 263 cases of pulmonary tuberculosis operated on at the Department of Thoracic Surgery, Seoul National University Hospital during the 19 year period, from January, 1957 to December 1975. Following observations were made: 1) The sex ratio was 2.8: 1 in male's favor, and 83.6% of the patients were between 20 and 49 years of age. 2) The trends in operative procedures revealed that surgical collapse as a definitive therapy of pulmonary tuberculosis has virtually disappeared and operations required for residuals of pleural diseases have increased. 3) The overall hospital mortality rate was 3-8%. The highest mortality rate was encountered in the cases of resection and decortication with 28.6%, 4) The rate of overall postoperative complications was 24.7%, the highest being encountered in decortication with 56.4%. 5) The most frequent cause of death was bleeding, while the dead space was the most frequent complication.

선천성엽성폐기종 - 1례 보고 -

홍장수,박주철,김종환,Hong, Jang-Soo,Park, Ju-Cheol,Kim, Jong-Hwan 대한흉부심장혈관외과학회 1977 Journal of Chest Surgery (J Chest Surg) Vol.10 No.1

Congenital lobar emphysema is one of the many causes of the respiratory distress syndrome in infant and an unusual condition barely mentioned before 1949, and only 166 cases were reported till 1967 in English literature This report describes a one-month-old boy who had a congenital middle lobar emphysema. The middle lobectomy was the operation for this case with complete cure.

적출심근 및 관상동맥에 대한 Nitroglycerin 의 작용

홍장수,서경필,김기환,Hong, Jang-Su,Seo, Gyeong-Pil,Kim, Gi-Hwan 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.3

With respect to controversial opinions concerning the nitroglycerin effects on cardiac muscle the direct nitroglycerin actions were thoroughly studied in isolated papillary muscles, atrial preparations and coronary strips of rabbits. Isometric active tension of papillary muscles developed at $35^{\circ}C$ upon electric stimulation at a rate of 60/min, was not affected by nitroglycerin up to a concentration of 10mg/L Higher concentrations of nitroglycerin, however, reduced action tension progressively. This depression of mechanical activity is accompanied by a decrease in oxygen consumption as measured by means of a flow respirometer. Resting oxygen uptake, on the other hand, remained unchanged. Similarly active tension of spontaneously beating atrial preparations also declined at a nitroglycerin concentration of more than 10 mg/L, whereas the sinus frequency did not change up to 40 mg/L. In contrast, rabbit coronary strips are much more sensitive to nitroglycerin and relax in a range of 10-100 ug/L of nitroglycerin concentration. The results indicate that the pharmacologic effects of nitroglycerin in coronary disease are due to vascular actions, because the plasma levels of nitroglycerin attainable in human therapy are not sufficiently high to directly influence the myocardium.

체-폐동맥 단락술 후 완전교정을 실시한 활로씨 4징증의 임상고찰

홍장수,김명인 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Four cases staged management were studied among the 45 patients of tetralogy of Fallot which were treated in Department of Chest Surgery in Chungnam National University Hospital between January 1983 and May 1989. Two male patients were children, and remain two patients were adult female. Total six shunt procedures were performed. In one patient Waterston-Cooley shunt, in one patient classical Blalock-Taussing shunt, in two patients modified and classical Blaock-Taussing shunt were carried out. The causes of second shunt operation was inadequte pulmonary arborization and small left ventricle. Three cases postshunt heart failure were noted, postoperative bleeding and pleural effusion in one case, and pulmonary artery deformity was noted in one case of Waterston-Cooley shunt procedure. But there was no operative death after shunt operation. The total correction was done mean 15.75 months later after initial shunt procedure. One case pulmonary valvotomy and three cases valvectomy were performed. The right ventricle outflow tract was reconstructed using bovine pericardial patch. There was no operative mortality after total correction.

간농양에 속발한 급성화농성 심 낭염 -1례 보고-

홍장수,노윤우 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.7

Pericardial abscess due to liver abscess is a very rare disease, the result of which is usually fatal when untreated. But a combination of antibiotics therapy and pericardial drainage has broug t good result. A 32-year-old man was admitted to the emergency room because of fever and chilling sensation. Chest X-ray showed cardiomegaly and a mass lesion In the left lobe of liver on ultrasonography. The echocardiography revealed impending cardiac tamponade. Pus drainage of the liver abscess through per- foration of right diaphram and pericardiotomy were performed. The pericardium was thickened and 600 ml of purulent fluid and necrotic debris were drained. Fibrin clots were firmly attached to the undelying myocradium. Histological examination of the pericardium showed acute inflammation with microabsscess and Escherichia soli was cultured from pericardial pus. He was discharged after 4 weeks on antibiotics, but Doppler echocardiograpy revealed a slightly thickened pericardium with a mild constrictive physiology. 간농양에 이은 급성 화농성 심낭염은 드문 질환이다. 급성화농성 심낭염은 적절한 치료가 이루어지지 않을 경우 사망율이 매우 높은 위 험한 질환이다. 환자는 32세 남자 환자로 발열, 오한, 상복부동통 및 호흡곤란을 주소로 응급실로 내원 하였다. 단순 흉부사진상 심비대의 소견을 보이고 있었으며, 복부초음파상 간좌엽에 종괴가 있었다. 심초음파상 임박 심장압진의 소견을 보이고 있었다. 응급으로 횡격막천공을 통해 간농양을 배농시켰고 심낭절개술을 시 행하였다. 심낭은 비후되어 두꺼워져 있었고 600m1의 악취가 나는 농액과 괴사조직들이 배액되었다. 섬유소응괴(abrinclot)가심근과유착이 있었다 조직학적 검사상심낭은급성 염증소견과 미세한 괴사 소견을 보이고 있었고, 균배양검사상 혈액과 배농액 에서 모두 Escherichia coli가 나왔다. 환자는 항생제 치료 받고 4주만에 퇴원 했고 심초음파상 약간의 교착성 심낭염의 소견을 보였다.

발살바동 동맥류 파열의 외과적 요법

홍장수 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

From May, 1985 to September, 1988, 4 patients who had ruptured congenital aneurysms of the sinus of Valsalva underwent corrective surgery in department of thoracic surgery, Chun gnam national university, college of medicine. All aneurysms originated from the right coronary sinus and ruptured to the right ventricle and ventricular septal defects were associated with them in all patients. The ruptured aneurysms were repaired through both the aorta and the right ventricle except one which was repaired through the aorta. There were no hospital deaths and the late results were excellent without significant complications in all patients.

청색증 선천성심장질환의 임상연구 : 활로 4징 증의 개심술

홍장수,한병선 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

Twenty-four cases of tetralogy of Fallot corrected totally using extracorporeal circulation in this department are presented during the period from April 1983 to August 1985. Of 24 cases, there were 20 cases of type Ⅱ ventricular septal defect and 4 cases of type Ⅰ defect. Types of right ventricular outflow tract obstruction were a case of pulmonic valvular stenosis, 2 cases of infundibular stenosis, and 21 cases of combined type. There were associated anomaly such as 3 caces of pulmonary arsenal hypoplasia, 3 cases of atrial septal defect, a case of left superior vena cava, and 2 cases of right side aortic arch. Transannular patch for right ventricular outflow tract reconstruction was necessary in 9 cases. Operative death was 5 cases and late death was a case, but other remaining cases followed up over 2 months carried out normal life,

유아 심실중격결손증의 개심술

홍장수 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

Ventricular septal defect repair was performed in 10 infants under 2 years in age and under l0kg in weight using conventional cardiopulmonary bypass from July, 1985, to November, 1987. The principal indication for operation was intractable chronic congestive heart failure in all but: one infant. There were two hospital deaths due to postoperative management error.

식도 근육내 낭종 1례

홍장수 대한흉부심장혈관외과학회 1981 Journal of Chest Surgery (J Chest Surg) Vol.14 No.1

Cystic intrathoracic lesions of foregut origin are now well recognized and account for approximately 10% of lesions presenting as mediastinal tumors. The terminology used to describe mediastinal endodermal cysts has been confused and sometimes ambiguous. The embryological derivation of these lesions has been the cause of much speculation. It Is suggested that these lesions should be classified Into three main categories based on embryology bronchogenic cyst[resulting from a defect of lung budding], Intramural esophageal cyst[true duplication], and enteric cyst[resulting from the split notochord syndrome]. This communication describes a 26 year old man with intramural esophageal cyst who was diagnosed as posterior medlastlnai tumor preoperatively and cured with extirpation of the cyst.

양성 식도질환의 임상적 고찰 : (Ⅰ) 부식성 식도협착 (Ⅰ) Corrosive Esophageal Stricture

홍장수 충남대학교 의과대학 지역사회의학연구소 1983 충남의대잡지 Vol.10 No.2

A clinical analysis was done on 18 cases of the corrosive esophageal strictures experienced at Department of Cardiothoracic Surgery, Chungnam National University Hospital from Jan. 1976 to Oct. 1983. Nine patients were male and nine were female, and ages ranged from twenty-two years to fifty years with peak incidence in third decade. Of 13 patients, corrosive agents wee sodium hydroxide in 9 patients, and strong acetic acid and hydrochloride in2, respectively. 11 patients ingested corrosive agent for suicidal purpose and remaining 2 patients were incidental cases. Of 13 patients, feeding gastrostomies were performed previously in 11 patients due to swallowing difficulty of soft fluid diet and within 1 year after ingestion of corrosive agent in 8 of 11 patients were performed. Proximal esophageal stricture developed most frquently in hypopharynx and middle one-third of thoracic esophagus. The operative procedures were performed in 12 patients of whom 8 patients had various kinds of esophageal reconstructive surgery. There were no operative deaths, but in all cases of reconstructive procedures complications developed; 4 anastomtic leaks with mild restenosis, 1 total disruption of anastomosis with complete obstruction, 2 anastomtic leaks, and 1 mild restenosis.