외상성 기관지 단절과 폐쇄의 수술 치험례

김혁,지행옥,Kim, Hyuck,Jee, Haeng-Ok 대한흉부심장혈관외과학회 1986 Journal of Chest Surgery (J Chest Surg) Vol.19 No.4

Rupture of the main bronchus following closed injury to the chest is a comparatively rare accident. The late recognition of this injury is attended by difficulties in management which may endanger life or expose the patient to distressing months and years of arduous therapy. This case was a 17 year old female who was a high school student. The patient had sustained a crushing injury to her right hemithorax and had been taken to an emergency hospital where right closed thoracostomy had been performed for a tension pneumothorax. She improved following this procedure but massive atelectasis of the right lung developed on the 13th day after trauma and transferred to our hospital. Bronchoscopy disclosed granulation tissue in the right main stem bronchus and end to end anastomosis of the bronchus was performed. Postoperative course was uneventful.

우심실유출로협착에 대한 심낭 Patch Graft 에 관한 임상적 연구

박정수,지행옥,김근호,Park, Jung-Soo,Jee, Haeng-Ok,Kim, Kun-Ho 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.1

The present study was performed to evaluate hemodynamic effects on the pericardial patch graft for stenosis of right ventricle outflow tract in 19 patients of tetralogy of Fallot. The stenosis of right ventricle outflow tract was associated with or without pulmonary annular nar-rowing, pulmonary valvular stenosis, and hypoplastic narrowing of pulmonary artery. Total correction of tetralogy of Fallot was performed under cardiopulmonary bypass with moderate hypothermia and cardioplegic cardiac arrest. Ventricular septal defects were closed with Teflon patch graft. The chamber pressures in the heart were measured before and after a total correction of tetralogy of Fallot. The data of pressure measurement and the results of postoperative observation of pericardial patch were as followings: 1. Systolic and diastolic pressure of right ventricle was decreased after operation from $96.0{\pm}14.7/10.0{\pm}14.4mmHg$ to $61.0{\pm}13.1/8.0{\pm}9.3mmHg$. 2. Systolic and diastolic pressure of pulmonary artery was increased after operation from $18.0{\pm}5.6/10.0{\pm}5.5mmHg$ to $31.0{\pm}10.7/14.0{\pm}4.9mmHg$. 3. Preoperative pressure gradient between right ventricle and pulmonary artery was decreased immediately after operation from 78.0mmHg to 30.0mmHg. 4. It was observed that excellent widening effects of right ventricle outflow tract was resulted from pericardial patch graft. 5. No postoperative bleeding from pericardial patch graft was observed. 6. Aneurysm formation of pericardial patch was not be observed during 1 to 6 years postoperative periods.

늑막 삼출 및 심막 삼출을 동반한 종격동 기형종

전양빈,손상태,전순호,정원상,김영학,김혁,강정호,지행옥,Jeon, Yang-Bin,Sohn, Sang-Tae,Chun, Sun-Ho,Chung, Won-Sang,Kim, Young-Hak,Kim, Hyuk,Kang, Jung-Ho,Jee, Haeng-Ok 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.4

종격동 기형종은 흉부외과의사가 흔치않게 수술하는 종양으로 무증상일 경우가 많다. 하지만 이 종양은 아주 드물게 늑막이나 심막을 침범하여 흉막 삼출이나 심낭 삼출, 심한 경우 심장압진으로 발전할 수도 있다. 종격동 기형종의 늑막 및 심막 침범, 파열의 기전은 잘 모르지만 종양 구성 조직요소가 작용을 하리라 의심된다. 본 예는 기형종이 늑막과 심막을 침범하여 흉막삼출과 심낭삼출을 유발한 경우로 환자는 종양과 심막 절제후 증상이 호전되었고 아무 문제없이 퇴원하였다. Mediastinal teratoma is a tumor that thoracic surgeons made an operation much less commonly than other mediastinal masses and most of them are asymptomatic. But very rarely, this tumor invades the pleura and pericardium resulting in pleural effusion, pericardial effusion and cardiac tamponade in severe cases. The mechanism of invasion and perforation of the tumor is unknown and tumor-consisting tissue factor is suspected of a cause. In this case, we operated on a patient whose anterior mediastinal teratoma invaded and perforated pericardium and pleura resulting in pericardial effusion and pleural effusion. The patient was improved and discharged with no problem after resection of mass and involved pericardium.

Cadmium Chloride가 흰쥐 폐포간 중격에 미치는 영향에 관한 전자현미경적 연구

오상준,지행옥 한양대학교 의과대학 1993 한양의대 학술지 Vol.13 No.1

It is known that cadmium, heavy metal, is very harmful and toxic to human bodies. Therefore, the chronic effects of cadmium chloride on the ultrastructures of rat alveolar septum were studied in 40 adult male rats (Wistar strain) by electron microscopy. Rats were intraperitoneally injected, once a week for 10 weeks, with cadmium cholride (3.75 mg/kg body weight) or saline as control. Animals were sacrificed 1 day, 1 week, and 2 weeks after the last injection. 1. in 1-day grou., large expanded air sacs were developed between the basal lamina and endothlial cells of capillaries. In the cytoplasm of great alveolar cell, lamellation of lamellated bodies was reduced and the smooth surfaced endoplsmic reticulum was in creased. 2. In 1-week group, alveolar wall capillaries were dilated and numerous areas of edema were seen in the alveolar septum. Great alveolar cells and fibroblasts were increased in number. 3. In 2-week group, the find structures of alveolar septum were intact such that they were similar to those of controls In conclusion, these findings suggest that cadmium chloride causes morphological changes of the lung alveolar septum in rats. Those changes, however, seem to normalize within 2 weeks following the last dose of cadmium chloride.

폐 상피양세포암 환자의 혈청과 암조직에서 폐암에 특이한 핵산분해 효소에 대한 연구

지행옥,정원상,고재경 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.1

In order to evaluate whether serum ribonuclease (RNase) and deoxyribinuclease (DNase) could be used as diagnostic and biochemical markers specific to the lung cancer, neutral RNase and acid DNase form the cancer tissue and serum of patients with epidermal carcinoma were separated by a ion exchange chromatography to find out the presence of the enzymes specific to the eqidermoid carcinoma. (1) Activities of neutral and alkaline RNases were unchanged in the epidermoid carcinoma tissue of the lung, but significantly increased in serum of the patients with the cancer. Acid RNase activity was significantly increased in both lung tissue and serum of the cancer. (2) Acid DNase activity was significantly increased in the epidermoid carcinoma tissue, but very low in both normal and the cancer patients serum. (3) Neutral RNase in the epidermoid carcinoma tissue of the lung were separated by a DEAE-cellulose column chromatography into 6 peaks, of which two peak RNases were specific to the cancer and two other peak RNases were activated. Neutral RNases in the serum of the lung cancer jwere separated into 5 peaks, of which four peak RNases were activated. (4) DEAE-cellulose column chromatographical analysis revaled that acid DNase was present in the epidermoid carcinoma tissue of the lung as a single form of enzyme, but no such enzyme was isolated in the serum of patients with the lung cancer. Results obtained in the present study indicated that at least two neutral RNases specific to the epidermoid carcinoma of the lung were present in the lung cancer tissue, but no definite evidence for the existence of the enzyme speicific to the lung cancer in serum was obtained.

폐상피양세포암 조직 acid deoxyribonuclease의 작용 기전에 관한 연구

고재경,지행옥,서의수 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.2

Activities of deoxyribonucleases (DNases) were determined in lung cancer tissues and were compared with those in the control lung tissuse. Of the DNases studied in the present work, acid DNase was isolated and purified from the epidermoid carcinoma tissue of the lung. The partially purified enzyme was used for characterizing properties of the acid DNase and for exploring the mechanism of action of the acid DNase from the epidermoid carcinoma of the lung. 1.Activities of acid, neutral and alkaline DNases in the lung cancer tissues were all singnificntly increased as compared with those in the control tissues of the lung, and the degree of increment in the enzyme activity was the highest in acid DNase of the epidermoid carcinoma tissue of the lung (129% increase). The positive rate of acid DNase in the lung tissue as a marker for epidermoid carcinoma of the lung as a biochemical marker for the epidermoid carcinoma of the lung. 2.DEAE-cellulose column chromatographical analysis for acid DNase and proteins in the control tissue and epidermoid carcinoma tissue of the lung revealed that tissue and that proteins were isorated into 7 peaks for the cancer tissue and 8 peaks for the control tissue. These results indicated that no acid DNase specific to the lung cancer was found in the cancer tissues and that a protein present in the control lung tissue disppeared from the lung cancer tissue. 3.Acid DNase in the epidermiod carcinoma tissue of the lung was partially purified by 58-fold by methods of centrifugation and an ion exchange column toward ds DNA and exhibited both endo-and exo-nuclease activities. These results indicate that acid DNase activity is significantly increased in the lung cancer tissue, but the possibility of the enzymed. Further studies are needed to purify the acid DNase more extensively to clearify and elucidate the mechanism of action of the enzyme in such tissues.

폐암조직의 핵산함량과 핵산분해 효소활성의 변동에 관한 연구

이철범,김근호,지행옥,고재경 한양대학교 의과대학 1987 한양의대 학술지 Vol.7 No.1

Nucleic acid and protein contents and activities of nucleis acid degrading enzymes in lung cancer tissues were determined and were compared with those in normal lung tissues to understand the abnormalities of nucleic acid metabolism in lung tissues. Nucleic acid degrading enzymes and proteins in lung tissues were isolated and fractionated by a DEAE-cellulose column chromatography to find out whether the enzymes and proteins specific to lung cancer might be present in the cancer tissues. Nucleic acid contents and deozyribonuclease (DNase) activity were significantly higher in lung cancer tissues than in normal lung tissues. The positive rates of DNA and RNA contents and DNase activity as markers for lung cancer were high suggesting that these parameters could be used as diagnostic markers. Ribonuclease (RNase) activities in lung cancer tissues and in serum of patients with lung cancer were significantly increased, but positive rate of serum RNase activity as a marker for lung cancer was low. DEAE-cellulose column chromatographical analyses for RNases and proteins in lung cancer tissues revealed that peak Ⅰ RNase appeared to be the enzyme specific to lung cancer and that non-RNase peak Ⅷ protein observed in normal lung tissues disappeared in lung cancer tissues. The significance of the abnormal chromatographical pattern in lung cancer has not clearly been understood.