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RISS 인기검색어
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- 저자 : 조중구(Jung-Ku Jo) (검색결과 4 건)
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김진,조중구,김공수,Kim, Jin,Jo, Jung-Ku,Kim, Kong-Soo 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.8
1983년 11월부터 1994년 3월까지 전북대학교 흉부외과학 교실에서는 중복 심장판막 수술 78예를 시행 하였다. 남자는 31명. 여자는 47명이 었고, 연령 분포는 14세 에서 63세까지이었다. 판막 손상의 원인으로는 섬유화가주병변인 류마티성 판막염이 57예로가장 많은 원인을 차지하였고, 퇴행성 변화가 19예, 그 외에 심내막염과 인조 판막의 기능 부전이 각각 1예씩 있었다. 이중 판막 치환술이 20예, 이중 판막 치환술과 삼첨 판 판륜 성 형술을 같이 시 행한 경우가 5예, 승모판 치환술과 대동맥 판막 성 형술을 시행한 경우가 2예, 승모판 치환술과 삼첨판판륜 성형술을 시행한 경우가 18예, 승모판 치환술과 대동맥 판막 성 형술과 삼첨 판 판륜 성형술을 같이 시행한 경우가 1예, 대동 맥 판막 치환술과 승모 판막 교련 절개술 또는 판륜 성형술을 시행한 경우가 10예, 대동맥 판막 치환술 과 삼첨판 판륜 성형술을 시행한 경우가 1예, 그리고 승모 판막 성형술 또는 교련 절개술과 대동맥 판막 성형술을 같이 시행한 경우가 8예, 승모 판막 성형술 또는 교련 절개술 또는 판륜 성 형술과 삼첨 판 판륜 성형술을 동시에 시행한 경우가 13예이었다. NYHA(New York Heart Association) 기능 분류는 수술전 평균 2.72에서 수술후 평균 1.21로 향상을 보였다 수술후 조기 사망은 5명으로 사망률은 6.4%이 었고, 사망 원인은 저심 박출증, 부정맥, 출혈, 뇌색 전증이 있었다. 퇴원 시의 NYHA의 평가는 모든 환자에서 I과 II 해당하였다. 인조 판막을 사용한 경우에 장기적 인 항응고제 투여를 하였고 prothrombin time을 30-50%로 유지하 였다. 추적 조사기 간중(93.6%, 평균 49.8개월) 사망은 2예가 있었으며, 사망 원인은 뇌실질내 출혈과 심부전 증이 었다. 조기 사망과 관련된 술전 임상 상태로 WYHA 기능 분류상 IV인 경우에 의 의가 있었다 (p<0.05). Multlvalvular heart surgery was performed In 78 cases, in the Department of Thoracic & Cardiovascu far Surgery of Chonbuk national University Hospital from november 1983 to March 1994. There Where 31 men and 47 women. whose ranged from 14 to 63 years. The causes of the valvular lesions were 57 rheumatic origin, 18 degenerative, 1 previous endocarditls, 1 prosthetic valve mal-function. There were 25 double valve replacement with or wit out tricuspid valve repair, i M VR and aortic valve repair, 18 MVR and tricuspid valve repair, 1 MVR and aortic and tricuspid valve repair, 10 AVR and mi- tral valve repair, 1 AVR and tricuspid valve repair, 8 mitral aortic valve repair, 13 mitral and tricuspid valve repair. They were improved mean New York Heart Association functional cldss, from 2.72% 121 Early deaths were 5 cases(6.4%). The cause of death wet'e low cArdiac output syndrome. veritricular tachycardia, massive bleeding and cerebral thromboembolism. All the survivors belonged to New York Heart Association functional class I or ll at discharge. The patients who had had valve replacement operation were medicated with warfarin to maintain the level of 30∼ 50% of normal prothrombin time. During follow-up(93.6%, mean 49.9 months), 2 late deaths were developed. One was due to intracranial hemorrhage and the other congestive heart failure. The pre-operative New York Heart Association Functional class IV was statistically sig ificant operat- ive risk factors(p< 0.05).
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김공수 ( Kong Soo Kim ),조중구 ( Jung Ku Jo ) 전북대학교 의과학연구소 2001 全北醫大論文集 Vol.25 No.2
Object: The purpose of this study was to evaluate the surgical result and to analysis the risk factors associated postoperative complications and death after surgical repair of ventricular septal defect(vsd). Material and Methods: Of the 163 patients, 88 were male and 75 were female. Age distribution was from 1 month to 41years (mean, 7.1 years). Body weight ranged from 3.48kg to 83.5kg. Preoperative mean pulmonary to systemic flow ratio(Qp/Qs) and pulmonary to systemic vascular resistance ratio(Rp/Rs) were 1.84, 0.20 respectively. Preoperative systolic pulmonary arterial pressure was 55 cases(41.0%) at 0-30mmHg. Results: 94 cases(58%) of patch closure and 69 cases(42%) of simple closure were perfomed. The most common type of VSD was perimembranous(105cases). Associated cardiac anomaly were found in 57(34.9%) patients, that patent foramen ovale was the most common cardiac anomaly(19cases). The postoperative complications such as right bundle branch block, atelectasis, low cardiac output syndrome, sepsis, respiratory insufficiency, aortic regurgitation, and remnant VSD were developed in 27(16.5%) patients and operative deaths were 9(5.5%) cases. Seven of the operative deaths occurred in infants under 4months of age and/or under 5kg of body weight. The major complications leading to deaths were complete heart block, sepsis, disseminated intravascular coagulation, and low cardiac output syndrome. Conclusion: In surgical correction for VSD patients under 4months of age and/or under 5Kg of body weight, further evaluation is needed to study on myocardial protection, operation technique and postoperative management for prevention and reduction of complication.
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조중구 전북대학교 의과학연구소 1984 全北醫大論文集 Vol.8 No.1
Mediastinal tumors or cysts were not common and one of the most challenging problems in making diagnosis. Because the symptom and sign appear late in their course, early diagnosis and proper treatment of the primary mediastinal tumors or cysts are difficult. And the exact diagnosis is rarely made before operation. Clinical study was performed on 13 cases of histophtho logically confirmed primary mediastinal tumors or cysts in dept. of thorac. and cardiovase. surg. Jeonbuk National hospital during the period from Jun. 1976 to Dec. 1982. The following results are obtained. of 13 cases, 8 were males and 5 were females. Age distribution was from 12 months to 42 years old with the highest incidence in second decade. The common subjective symptoms were coughing(46%), dyspnea(31%), anterior chest pain(31%) and blood-ginged sputum(23%). The symptomatic patients were 12 cases(92%) and the asymptomatic was 1 case(8%). Diagnostic procedures were PA and lateral chest X-ray, chest tomograms, bronchogram, esophagogram, mediastinoscopy, scalene and axillary lymph node biopsy, and exploratory thoracotomies. The most common histologic type was lymphoma(31%), and followed by teratoma(23%), neurogenic tumor(155) and hemangioma(15%). Of the 13 cases of the histologically confirmed mediastinal tumors, 8 were benign tumors and 5 were malignants. 8 cases of bening tumors were surgically resected with good results but one case of surgically resected malignant thymoma was recurred 4 months later. 4 cases of malignant lymphoma and one case of recurred malignant thymoma were treated with chemotherapy. There was no case of postoperative mortality.
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