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정원상,전양빈,전순호,김혁,이철범,김영학,지행옥,서정국,공구,Chung, Won-Sang,Jeon, Yang-Bin,Chun, Soon-Ho,Kim, Hyuk,Lee, Chul-Burm,Kim, Young-Hak,Jee, Heng-Ok,Seo, Jung-Kuk,Kong, Gu 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.5
국내에서 심장, 폐이식이 각 대학병원에서 점차 확산 시행되고는 있으나, 이에 따른 기초실험이 뒷받침되지 않고, 큰 동물에서는 많은 실험비용이 들어 보다 적은 동물을 이용하게 되었으나 이 방법은 현미경하의 미세수술기법의 발달과 더불어 발전하게 되었다. 본 연구는 현미경하의 미세수술기법으로 쥐모델에서 복부의 대동맥과 하공정맥에 다른 쥐의 공여심장의 대동맥과 폐동맥을 각각 문합술로 연결하는 방법으로 이식하여 동종이형의 장기이식에 따른 거부반응과 면역억제제를 투여하여 그에 따른 생존율을 비교하고자 하였다. 체중 150∼250 gm의 흰쥐의 심장을 공여 및 이식하는 바, 이소성의 심장이식후 면역억제제를 투여하지 않은 군과 면역억제제를 투여한 군으로 나누고, 각 군에서 복부에 이식된 심장의 박동을 매일 만져보고서 만져지지 않을 경우는 이식된 심장이 거부반응에 따른 것으로 판단하여 이의 생존율을 비교 검토하여본 바, 면역억제제를 투여하지 않은 군에서보다 투여한 군에서 오래 생존하여 동종이형의 이식에서 면역억제제를 투여하므로써 장기이식에 따른 장기성적을 향상시킴을 알 수 있었다. In 1964, Abbott and Colleagues published the world's first heterotopic heart transplantation technique in the rat. Their method established circulation by end-to-end anastomoses of the graft's aorta and pulmonary artery to the recipient's abdominal aorta and Inferior Vena Cava(IVC), respectively. In 1966, Tomita et al altered Abbott's technique by employing end-to-side rather than end-to-end anastomoses, thus eliminating the hind leg paralysis that sometimes resulted from Abbott's technique. In order to prevent postsuture hemorrhage (since 7-0 silk suture was the finest available at that time), Tomita's aortic anastomosis was done with double up-and-down continuous suture technique. A single layer continuous anstomosis effected the pulmonary artery-IVC anastomosis. The availability of Nylon monofilament suture made it possible for Ono and Lindsey to use a single layer suture technique for the aortic end-to-side anastomosis in their modified rat heart transplantation. We observed survival time between control group and Immunosuppression(Cyclosporine administration, 10mg/Kg${\times}$4 times postoperatively) group after heterotopic heart transplantation in the rat model. The cyclosporine adminstration group survived longer than the control group, thus we concluded that cyclosporine was based on Immunosuppressive drugs.
송동섭,정원상,김혁,김영학,강정호,이철범,전석철,이원미,홍은경,Song, Dong-Seop,Chung, Won-Sang,Kim, Hyuck,Kim, Young-Hak,Kang, Jung-Ho,Lee, Chul-Bum,Jeon, Seok-Chol,Lee, Won-Mi,Hong, Eun-Kyung 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.7
잘 분화된 태아성 선암종은 조직학적으로 폐모세포종과 유사하여, 폐모세포종의 한 분류로 생각되어지며, 육종성 형태와 상피성 형태 사이의 태아성 폐에 유사한 상피성 형태를 보인다. 최근 저자등은 19세 남자 환자에서 폐의 좌상엽 부위에 발생한 종괴에 미세 흡침 조직 검사상 폐모세포종으로 나와 좌상엽 절제술을 시행하였고, 술 후 시행한 조직 검사상 육종성 형태는 없었으며, 잘 분화된 태아성 선암종으로 확진되어 문헌고찰과 함께 보고하는 바이다. WDFA(Well-differentiated fetal adenocarcinoma) histologically resembles pulmonary blastoma. It is also thought to be a subtype of pulmonary blastoma, which has differentiated epithelial features resembling the fetal lung among its epithelial features and sarcomatous features. We recently encounted a patient who underwent surgery for WDFA. A 19-year-old man had a mass shadow in the upper lobe of the left lung. The tumor was diagnosed as pulmonary blastoma as a result of fine needle aspiration biopsy, and left upper lobe lobectomy was performed. No sarcomatous features was observed on postoperative histologic assessment, and the patient was diagnosed as having WDFA. This case is reported with a discussion of the literatures.
결핵성 파괴폐의 수술적 치료에 대한 술후 이환율과 사망률에 영향을 미치는 위험 인자에 대한 임상고찰
신성호,정원상,지행옥,강정호,김영학,김혁,Shin, Sung-Ho,Chung, Won-Sang,Jee, Heng-Ok,Kang, Jung-Ho,Kim, Young-Hak,Kim, Hyuck 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.3
Background: This retrospective study tries to identify specific risk factors that may increase complication rates after the surgical treatment of tuberculous destroyed lung. Material and method: A retrospective study was performed on forty-seven patients, who received surgical treatment for tuberculous destroyed lung in the Department of Thoracic and Cardiovascular Surgery at Hanyang University Hospital from 1988 to 1998, to identify specific preoperative risk factors related to postoperative complications. Fisher's exact test was used to identify the correlations between the complications and right pneumonectomy, preoperative FEV1, predicted postoperative FEV1, massive hemoptysis, postoperative persistent empyema. Result: Hospital mortality and morbidity rates of the patients who received surgical treatment for tuberculous destroyed lung were 6.4% and 29.7%, respectively. In view of the hospital mortality and morbidity rates as a whole, predicted postoperative FEV1 less than 0.8L(p<0.005), preoperative FEV1 less than 1.8L(p=0.01), massive hemoptysis(p<0.005), postoperative persistent positive sputum cultures(p<0.0005), and the presence of multi drug resistant tuberculosis(p<0.05) presented statistically significant correlations. Among the postoperative complications, bronchopleural fistula, the most common complication, was found to have statistically significant corrleations with the preoperative empyema(p<0.05) and postoperative persistent positive sputum cultures(p<0.05). Conclusion: Although mortality and morbidity rates after surgical treatment of tuberculous destroyed lung were relatively low, when predicted postoperative FEV1 was less than 0.8L, when preoperative FEV1 was less than 1.8L, when massive hemoptysis was present, when postoperative sputum cultures were persistently positive, and when multi drug resistant tuberculosis was present, the rates were significantly higher.
소아의 흉벽에 발생한 Langerhans 세포 조직구증의 치료 - 1례 보고 -
송동섭,지행옥,정원상,강정호,김영학,김혁,이철범,함시영,전석철,이원미,박찬금,Song, Dong-Seop,Lee, Heng-Ok,Chung, Won-Sang,Kang, Jung-Ho,Kim, Young-Hak,Kim, Hyuck,Lee, Chul-Bum,Ham, Shi-Young,Jeon, Seok-Chol,Lee, Won-Mi,Park, Chan-Kum 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.6
Langerhans 세포 조직구증(LCH, Langerhans\` Cell Histiocytosis)은 Langerhans\` cell histiocyte의 이상 증식을 특징으로 하는 원인 불명의 질환이다. 이 질환은 eosinophilic granuloma, Hand-Sch ller-Christian씨 병, Letterer-Siwe병을 포함하는 것으로 과거에는 histiocytosis X로 불리던 질환이다. 피부, 림프절, 골, 골수 및 체내 모든 조직과 기관을 침범할 수 있으나 국내에서 흉벽에서 발생된 예는 보고된 증례가 많지않다. 18개월 된 남자 환아에서 흉벽의 늑골에서 기원하여 골용해 소견을 동반한 종괴가 있어 수술적 절제한 후 LCH로 확진된 증례가 있어 문헌고찰과 함께 보고하는 바이다 Langerhans\` Cell Histiocytosis(LCH) is a disease of unknown origin, characterized by abnormal proliferation of Langerhans\` cells. Previously, it has been called histiocytosis X, which included eosinophilic granuloma, Hand-Sch ller-Christian\`s disease, and Letterer-Siwe disease. Any organs or tissues such as skin, lymph nodes, bone and bone marrow can be involved. However, LCH of chest wall is rarely reported in our country. We experienced a 18 month old male child, who had osteolytic lesion involving the rib with axillary lymph node metastasis. The tumor was confirmed as LCH after surgery.