관통성 흉부손상 176례에 대한 임상적 고찰

허용,유회성,Hur, Y.,Yu, H.S. 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.1

Although most patients with penetrating injuries can be managed successfully with early tube thoracotomy, blood volume replacement & close observation, the remainder can be saved only by an aggressive operative intervention. From January 1959, to August 1980, 176 cases with penetrating injuries had been treated at the Department of Cardiothoracic Surgery, National Medical Center. The ratio of male to female patient of penetrating chest wounds was 4.3:1 in male predominance and age from 10 to 40 occupied 76.7% of the total cases. Stab wounds was the most common penetrating injuries and followed by gunshot & glass wounds. To prevent early complications of penetrating chest injuries, thoracentesis were done in 29 cases [16%], and closed thoractomy in 40 cases [22.7%]. Open thoractomy, however, had to be done in 37 cases [21%] because of massive bleeding, hemopericardium, foreign body.

성인의 선천성 식도.기관지루 6례 보고

허용,강경훈,문경훈,김병열,이정호,유회성,손진희,박효숙,Hur, Y.,Kang, K.H.,Moon, K.H.,Kim, B.Y.,Lee, J.H.,Yu, H.S.,Sohn, J.H.,Park, H.S. 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.3

We had been experienced 6 cases of congenital esophagobronchial fistula which underwent surgical intervention in all cases. Of the 6 patients, 5 patients were male, one patient was female. The mean age of patients was 37.8 years old and clinical symptom free period was 27.1 years. According to Braimbridge`s classification, they were belonged to the type II[3 cases], type III[2 cases], <% type I[1 case]. Pre-operative diagnosis was available in 4 cases and the 2 cases could be diagnosed at operation field. The fistulectomy were performed in all cases, concomitant segmental resection[1 case], lobectomy[1 case], bi-lobectomy[1 case], and pneumonectomy[3 cases] were combined.

식도질환의 외과적 수술에 대한 임상적 고찰

허용,이강식,이재진,김병열,이정호,유회성,Hur, Y.,Lee, K.S.,Lee, J.J,Kim, B.Y,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.6

Since Jan. 1957, 142 cases of benign esophageal stricture, 55 males and 87 females, were managed in our hospital, and their ages ranged from 3 to 77 years. old[mean 31.2yrs]. The most common cause was caustic burns and they all complained dysphagia and some loss of weight, general malaise and substernal pain, which usually appeared in 1 month to 1 year after ingestion of corrosive agents. The mid 1/3 of the thoracic esophagus was the most prevalent portion[29%] but rather evenly distributed along the entire esophagus. Operations were done on 129 patients, of whom 50 patients had ECG[esophagocologastrostomy], 5 PCG[pharyn-gocologastrostomy], 34 EG[esophagogastrostomy], 4 EJG[esophagojejunogastrostomy], 3 PG[pharyngogastrostomy], 2 esophageal end to end anastomosis and 31 Gastrostomy. There were 6 deaths in the postoperative period, so its operative mortality was 4.7%, among them 3 were ECG cases, 2 EG and 1 EJG. And 34 complications occurred so it recorded 24% complication rate. and in details in ECG 46%, PCG 60%, EG 17.6%, EJG 25%, and PG 33%. When we reviewed periodic variations, the mortality rate of the first 20 yrs. period was 6.9%, next 10yrs. 2.6% and now for last 2yrs non.

폐암의 임상적 고찰 (III)

허용,유환국,안욱수,김병열,이정호,유회성,Hur, Y.,Yu, H.K.,Ahn, W.S.,Kim, B.Y.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

A total of 129 patients with a confirmed diagnosis of primary lung cancer were treated at Dep. of Thoracic k Cardiovascular Surgery, National Medical Center, Seoul, Korea, between July, 1981 and Dec., 1988. Particular emphasis was given in this review to the 72 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The age group of fifty k sixty decade occupied 55.8 %, and the youngest being 24 years and oldest 78 years. The incidence ratio of male to female was 3,2:1. The subjective symptoms of the patients were coughing [72.6%], chest pain [48.2%] and hemoptysis [35.6%], which were due to primary local influence. The confirmed diagnostic procedures were bronchoscopic biopsy, sputum cytology needle aspiration biopsy, open lung biopsy, anterior mediastinotomy & lymph node biopsy. By pathologic classifications, the squamous cell carcinoma was the most prevalent, 67 cases [51.9 %], and the adenocarcinoma in 36 cases [27.9%], undifferentiated small cell carcinoma in 13 cases [10.1 %], undifferentiated large cell carcinoma in 9 cases [6.9%], bronchioloalveolar carcinoma was 4 cases [3.1%]. The lymph node dissection with pneumonectomy [42 cases], lobectomy [14 cases] and pneumonectomy [6 cases], lobectomy [9 cases] without lymph node dissection were performed. The post operative TNM Staging[AJC] in 72 cases were Stage I in 24 cases, Stage II in 27 cases, and Stage III in 21 cases. Overall resectable was possible in 72 cases [55.8 %], and the operation mortality was 5.6 % [4 cases].

국산 프로폴리스의 항균 및 내성균 억제 활성 검증

허용갑(Yong-kap Hur),김나래(Na-rae Kim),윤원경(Won-kyung Yoon),조성기(Sung-kee Jo),정우희(U-hee Jung),박혜란(Hae-ran Park) 한국양봉학회 2007 韓國養蜂學會誌 Vol.22 No.1

대동맥 축착증 1례 보고

허용,안욱수,류병하,김병열,장운하,이정호,유회성,Hur, Y.,Ahn, W.S.,Yoo, B.H.,Kim, B.Y.,Chang, U.H.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.3

Coarctation of the aorta is a congenital constriction of the aorta of varying degree usually located slightly distal to the origin of the left subclavian artery. This congenital malformation is found at 5-9% of the congenital heart disease in Europe & North America, but in our country, it is reported as one of rare malformations. We present a case of coarctation of the aorta, which had double diaphragms as discrete form. This is 9 year-old boy, who has suffered from hypertensive symptoms since 6 years before. Coarctation of the aorta was confirmed by aortography, and there was no combined anomalies, and it was postductal type, and coarctations were consisted of two diaphragmatic webs at the both ends with a central aneurysmized. After resection of the coarctated segment completely, Woven Dacron graft was inserted with 18mm in diameter & 2.5cm in length successfully.

승모판막질환에 병발한 동맥색전증의 치험 1례

허용,김병열,이홍섭,김주이,이정호,유회성,Hur, Y.,Kim, B.Y.,Lee, H.S.,Kim, J.E.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.1

We present one case of 26-year-old male having saddle block combined with mitral valvular disease [NYHA Class IV] with auricular fibrillation. The most common cause of emboli is atrial fibrillation. The clinical manifestations of saddle emboli are relatively slow due to development of collateral circulation and large size of lumen of the aorta. The 5month duration of saddle emboli in this case led to severe atrophic changes, coldness, peripheral cyanosis on the both lower extremities, and flexion deformity on the knee and ankle joint of the left lower extremity. We planned staged operation for the saddle block and for mitral stenoinsufficiency and tricuspid insufficiency, because of poor general condition of the patient. The thromboembolectomy of aortic bifurcation was performed through the transabdominal approach without trial of Fogarthy catheter embolectomy, because of expectation of the secondary inflammatory changes of the vessel wall and thrombi which was 3 cm X 1 cm X 0.5 cm in size with irregular surfaced solid in consistency. 1 month later, after thromboembolectomy, mitral valve replacement and tricuspid annuloplasty were performed, with successful early operative result. During operation organized thrombi [1 cm X 0.5 cm] in the left auricle was removed. We wonder if simple management using Fogarthy catheter might be possible to remove the thromboemboli instead of thromboembolectomy by aortotomy in this case.

유경성 대망 이식편을 이용한 농흉 치험 3례

허용,문준호,안욱수,김병일,이정호,유희성,Hur, Y.,Moon, J.H.,Ahn, W.S.,Kim, B.Y.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.8

The omental pedicle flap[OFF] has been used for management of complicated problems in various fields of cardiovascular surgery. Its unique properties of enhancing neovascularity, relieving lymphedema, providing fibroblasts to promote healing, providing soft tissue coverage, & functioning in the face of existing infection make it ideal in managing many of the more complicated problems facing the thoracic surgeon. We have used omental pedicle for colosing of the bronchial fistula R esophageal fistula with filling the adjoining cavity after pneumonectomy. The successful closure of the bronchial stump with OFF were obtained in 2 cases, but one case was failed who was suffered from the esophageal fistula. The primary operation in each cases were right pleuropneumonctomy for tuberculous empyema in 2 cases & left pneumonectomy for chronic empyema in 1 case, We believe that the OFF is effective for closing fistula due to postoperative empyema k plombage procedures for dead space of infected thoracic cavity.

Completion pneumonectomy의 임상적 고찰;11례 임상보고

허용,박재홍,문준호,차경태,안욱수,김병열,이정호,유회성,Hur, Yong,Park, Jae-Hong,Moon, Joon-Ho,Cha, Kyong-Tae,Ahn, Wook-Soo,Kim, Byung-Yul,Lee, Jung-Ho,Yu, Hoe-Sung 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.11

Among elevn consecutive cases having undergone Completion Pueumonectomy[CP]between 1958 and Aug. 1993 at the Dep. of Thoracic & Cardiovascular Surgery in National Medical Center. The patient`s mean age was 43 years[range 28 yrs, to 68yrs.],& they consisted with 10 males and 1 female. The indications for CP were benign diseases in 9 cases & 2 cases of lung cancer. The mean interval between the first operation & CP was 62.3 months[from 17 days to 288 months]. The several special intraoperative procedures such as intrapericardial pulmonary vesselsdivision & suture ligation, reinforcement of bronchial stumpmargin, & applied the Fibrin glue & hemostatics. The mean intra operative bleeding was 3582ml.[1500ml. to 6500ml.] The post orerative complication were developed in 5 cases[45.5%] they were empyema with BPF in 2 cases, empyema in 2 cases, & 1 case of repiratoy insufficiency which leading to death. We concluded that the C P noted high morbidity & mortality compared with ordinary first pulmonary resectional surgery. But, it will be a challenge to improved the morbidity because of increasing trend of completion pneumonectomy in a furture time.

자연기흉의 외과적 치료

허용,김경훈,김철환,박성동,박해홍,문준호,김병열,이정호,Hur, Yong,Kim, Kyung-Hoon,Kim, Chul-Whan,Park, Sung-Dong,Park, Jae-Hong,Moon, Joon-Ho,Kim, Byung-Yul,Lee, Jung-Ho 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.12

The spontaneous pneumothorax occurs subsequent to a disruption in the continuity of the visceral pleura with escape of free air into the pleural space included primary & secondary pneumothorax that is unrelated to identifiable etiologies such as trauma. In. the 33 year period 1960 to 1993, the 230 cases of open thoracotomy were carried out for definitive treatment of spontaneous pneumothorax, at the Dept. of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 193 men & 37 women. They ranged in age from 15 years old to 72 years old. The lesion site was on the right side in 117 and on the left in 97, the 16 cases were in bilateral lesions.Surgical indications included recurrence in 98 cases, persistent air leak in 68 cases, nonexpansion of the lung 37 cases, roentgenologically apparent bullae & blebs in 23 cases, bilateral lesions in 16 cases,combined hemothorax & prevent for recurrence in each 2 cases. The types of operation were bullectomy in 207 cases, wedge resection in 13 cases, decortication & B.P.F. closure in 6 cases,lobectomy in 2 cases, pneumonectomy, plication in each I case. The post operative complication developed in 18 cases[7.8 %], there was I case of death due to sepsis. We believed that open thoracotomy with resection or obliteration of blebs & pleurodes is provided the best protection against recurrence.