鍼·灸 및 Colchicine이 Microcrysyalline Sodium Urate 投與 흰쥐의 痛風에 미치는 影響

金三顯,崔容泰 慶熙大學校韓醫科大學韓醫學硏究所 1988 慶熙韓醫大論文集 Vol.11 No.-

Cardiac type 총폐정맥 이상환류증 수술치험 3

김삼현 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.2

Majority of patients with total anomalous pulmonary venous drainage [TAPVD] have severe symptoms within the first few months of life. And early in the experience with correction of TAPVD, hospital mortality was high, especially in infant. In Sejong General Hospital, we operated on 3 infants with TAPVD of cardiac type. Repair was performed under the conventional cardiopulmonary by pass in one case and by the total circulatory arrest in other 2 cases. Interatial septum between enlarged coronary sinus opening and interatrial septal defect was excised and the coronary sinus was radically unroofed to make wide opening between left atrium and common pulmonary venous channel. The defect in atrial septum was closed with redundant pericardial patch. Postoperative courses were uneventful except transient dysrrhythmia of A-V dissociation. They are doing well on follow up check.

개심술후 유미심낭 (Chylopericardium) 합병증의 수술치험 1예

김삼현 대한흉부심장혈관외과학회 1986 Journal of Chest Surgery (J Chest Surg) Vol.19 No.4

Only five instances of chylopericardium following cardiac surgery have been reported in the literature previously. We encounted this complication in a patient who was operated on for secundum atrial septal defect. The patient readmitted one month after discharge because of large amount of chylous pericardial effusion. Conservative treatment of pericardiostomy drainage and parenteral hyperalimentation was continued for 3 weeks without improvement. Partial pericardiectomy and pericardiopleural window was done with success and no recurrence of chylopericardium was observed upto 3 months after surgery. We think this is the first case report of chylopericardium after open heart surgery in Korea.

Ebstein`s 심기형의 개심수술 8예

김삼현 대한흉부심장혈관외과학회 1981 Journal of Chest Surgery (J Chest Surg) Vol.14 No.4

Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

폐혈류유출로협착을 동반한 양대혈관 우심기시증의 수술치험

김삼현 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.2

The results of surgical experience of double outlet right ventricle with pulmonic stenosis in 14 patients are reported. Among the 14 patients, 8 underwent the intraventricular tunnel repair with the result of 3 hospital deaths, 5 had Fontan type operations due to the various anatomic reasons and resulted in one hospital death, and the remaining one patient had palliative pulmonary valvotomy. Besides the problems related to the effective relief of the pulmonic stenosis, double outlet right ventricle with pulmonic stenosis may present a surgical challenge because severe associated anomalies which definitely complicate their repair are not uncommon. We describe the anatomic details of our 14 cases of DORV with PS and the surgical results. The results having been unsatisfactory, more meticulous diagnostic studies for the detailed intracardiac morphologies and the strict indication for their repair with the refinement of surgical technique seem necessary for the better surgical results.

대동맥 교약증의 치험 2례

김삼현 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.1

Coarctation of the aorta, a well known congenital cardiovascular defect, can be recognized in most instances by simple findings of physical examination. This condition shortens life if untreated, but it can be corrected surgically to render the patient functionally normal. It seems relatively rare in Asian. We experienced two cases of coarctation of the aorta which were treated surgically. The first case was 17 years old male with juxtaductal type of coarctation of the aorta. The second was 7 years old female with preductal type of coarctation of the aorta and combined anomaly of PDA and she had been in congestive heart failure. In both cases, coarctated segments of the aorta were resected and end to end anastomosis were performed. In the second case, PDA was closed by division before resection of the coarctated segment. The postoperative courses were uneventful. They discharged 2 weeks postoperatively without any complications. Blood pressure was nearly normalized at the time of follow up check.

좌심방내 점액종 치험 2예

김삼현 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.1

Left atrial myxoma, an unusual clinical entity, may cause severe and progressive cardiac disease mimicking mitral valvular disease. In recent years, increased clinical awareness and improved diagnostic techniques has led to a higher incidence of correct preoperative diagnosis. Recently we experienced 2 cases of left atrial myxoma, which were removed successfully under the cardiopulmonary by pass. The first case was 45 years old woman and the second was 23 years old female. Preoperative definite diagnosis was entertained by angiocardiography and echocardiography in both cases. In the first case, tumor was removed with left atriotomy and atrial septectomy was done with additional right atriotomy. In the second case, tumor and atrial septum were removed en bloc through the right atrium. Both patients were discharged with good results 2 weeks postoperatively.

활로 3 증: 개심교정 7예

김삼현 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.2

자연기흉의 외과적 치료 -310례의 임상고찰-

김삼현 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.1

Total 310 cases of spontaneous pneumothorax in 281 patients were analyzed to review the results of surgical treatment for this condition. Clinical data on the age & sex distribution, recurrence, etiologic conditions and on the other aspects of spontaneous neumothorax were summarized. The results of surgical management of spontaneous pneumothorax are followings; 205 out of 310 cases[66.1%] were cured by closed thoracostomies. 82 cases[26.5%] were cured by thoracotomy. The indications of thoracotomy were 1] persistent air leakage, 2] history of recurrences, 3] blebs or bullae on thoracoscopy, 4] associated parenchymal lesion, 5] pneumothorax caused by paragonimiasis. Other reasons of thoracotomy were bilateral pneumothorax and inadequate expansion due to chronicity. Excision of blebs or wedge resection was performed in most cases with good result. Lobectomy [9 case] or pneumonectomy [3 cases] was carried out depending on the pathological involvement of the lung. There was no operative death and only one case showed recurrent pneumothorax during follow-up after thoracotomy.

심실간 중격결손을 동반한 폐동맥 폐쇄증의 일차 고식적 수술

김삼현 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.1

The ideal approach in the staged management of patients with pulmonary atresia has been a challenging problem and the result has not been always satisfactory. We reviewed our early result of initial palliative surgeries in fifteen cases of pulmonary atresia with interventricular communication Included are eight cases of simple pulmonary atresia with ventricular septal defect and seven cases of pulmonary atresia associated with other complex cardiac anomalies. The ages of the patients were less than one year except one. The morphology of pulmonary vasculature was highly variable and showed unfavorable conditions in most cases. Pulmonary artery was nonconfluent in two. Two-thirds of all cases showed significant problems such as juxtaductal stenosis or diffuse hypoplasia. The ductus arteriosus usually narrowed at its pulmonic end. Initial palliation was done by modified Blalock-Taussig shunt in six, central shunt with or without pulmonary angioplasty in five, right ventricular outflow tract [RVOT] reconstruction in three and direct connection of nonconfluent pulmonary arteries with bilateral cav-opulmonary shunt in one patient. There were 3 hospital deaths. Two of them underwent simultaneous repair of the associated anomaly of TAPVR. Among the six patients who received modified Blalock-Taussig shunt, three needed early second palliative procedure by central shunt, RVOT patch reconstruction and pulmonary angioplasty in each case, All patients who received central shunt showed marked clinical improvement. Among the twelve patients who survived the palliative procedures, two patients underwent total correction 13 months and 18 months after initial palliation respectively. We think that the choice of palliative procedure must be individualized according to the morphology of the pulmonary arteries. More experience and long term follow-up data are necessary to meet this challenging problem.