동맥간(動脈幹) 1례(例) 보고(報告)

홍장수,박주철,노준량,김종환,서경필,이영균,Hong, Jang Soo,Park, Joo Chul,Rho, Joon Ryang,Kim, Chong Whan,Suh, Kyung Phil,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

Truncus arteriosus is a rare and highly lethal cardiac anomaly characterized by a single arterial trunk emerging from the heart and supplying the coronary, systemic, and pulmonary circulations, The first successful correction of truncus arteriosus was reported by McGoon et al. in 1968 and was based on experimental work reported by Rastelli et al. in 1967 in which a conduit consisting of a homograft of the ascending aorta and aortic valve was used to establish continuity between the right ventricle and the pulmonary arteries, Modification of this procedure using a Dacron tube valved with porcine xenograft instead of a homograft have resulted in the current definite treatment for truncus arteriosus. This report describes an 3 years and 4 months old boy with heart failure from type I truncus arteriosus who was diagnosed as the V. S. D. with pulmonary hypertension preoperatively and underwent corrective surgery employing the Rastelli procedure using a Dacron conduit valved with canine xenograft, but died due to massive bleeding from the anastomosis sites in operating room.

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.

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.

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.

기관지 확장증의 임상적 연구

홍장수 충남대학교 의과대학 지역사회의학연구소 1982 충남의대잡지 Vol.9 No.2

The incidence of bronchiectasis has been drastically decreased with the advent of antibiotics in developed country, however, in our country, it is still one of common diseases in thoracic surgical field. The author reviewed 24 cases of bronchiectasis treated at the department of thoracic surgery, Chungnam National University Hospital from January, 1976 to August, 1982 and the following observations were obtained. 1. The peak age incidence of admission was third decade and approximately 62.5% of 24 cases occurred in patients less than 30 years of age. 2. In half cases, the etiologic factors were found as childhood pulmonary infections (37.5%) and pulmonary tuberculosis(12, 5%) 3. Bronchography revealed that in 71.4% of 21 cases the left lung was involved and in 95.2% of them the lower lobe was involved. 4. There was no operative death. The operative complications were 1 case of pneumonia and 3 cases of broncho-pulmonary fistula and/or empyema(20%). We followed up all operative cases at out patient department at least 3 months after discharge and they showed complete relief of symptoms in unilateral cases and marked improvement in bilateral cases.

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.

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.

흉막의 침생검에 관한 임상적 연구 : A Review of 15 Cases of Pleural Biopsies

홍장수 충남대학교 의과대학 지역사회의학연구소 1981 충남의대잡지 Vol.8 No.2

A clinical study was made of 13 patients with pleural effusions to whom 15 cases of pleural biopsies were performed using Cope needle in the Dept. of Thoracic Surgery, Chung-nam National University Hospital from August 1976 to late October 1981 and previously reported literatures were reviewed. The following results were obtained. 1) Parietal pleura was obtained in all cases of 15 pleural biopsies. 2) The obtained histologic results were tuberculous pleuritis in 4 patients, malignant pleuritis in 1 patient, and non-specific pleuritis in 8 patients. 3) Defenite histologic diagnoses were made in 6 patients of 13 patients, so the rate of defenite diagnosis was 46%. 4) Of 5 patients of proven tuberculous pleuritis, the results of pleural biopsies were positive in 4 patients and of 2 patient of proven malignant pleuritis, positive in 1 patient. 5) For diagnosis of idiopathic pleural effusions, Cope needle biopsy is very effective and must be performed in those instances.

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,

심실중격 결손증의 개심술

홍장수 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

Twelve cases of ventricular septal defect closed using extracoporeal circulation in this department are presented during the period from April 1983 to September 1984. Out of twelve cases, there were eleven cases of type II defect and one case of Type I defect. A three years old boy was dead due to ventilatory failure on first postoperative day, but the other eleven cases followed up over two months carried out normal life.