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.

동백질환의 임상적 고찰

이정호,김주이,유회성,Lee, J.H.,Kim, J.E.,Yu, H.S. 대한심장혈관흉부외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.4

From 1959 to 1980, for about 21 yrs, the authors have experienced of 69 cases of arterial diseases, and analyzed the diseases. They are Aneurysm 16 Iatrogenic thrombosis after angio & cardiac Cath. 20 Coarctation 3 Primary arteritis 9 Traumatic injury 9 Occlusive disease 12 But PDA (107 cases) & Buerger's disease are excluded in this study.

영아에 발생(發生)한 거대(巨大) 기낭성폐기종(氣囊性肺氣腫) 2례(例) 보고(報告)

김주이,최수승,이정호,유영선,유회성,박문향,박효숙,Kim, J.E.,Choi, S.S.,Lee, J.H.,Yoo, Y.S.,Yu, H.S.,Park, M.H.,Park, H.S. 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.1

Bullous emphysema is usually associated with extensive chronic obliterative pulmonary disease. It is the disease of old age but rare in children or infancy. The bulla in this disease is acquired one. In general the symptoms are due to not the mere presence of the bulla but the extent of underlying lung pathology as emphysema or bronchitis. Occassionally giant bulla of great size may cause symptoms and in this occassion it should be differentiated from other diseases. Especially in children or infancy pneumothorax, congenital pulmonary cyst of lobar obstructive-emphysema should be excluded. Recently we experienced 2 cases of bullous emphysema in infancy with severe respiratory symptoms because of bullae of great size. We felt difficulties in differentiating with other conditions. The purpose of this report is to review our cases thoroughly and enhance considerations of this disease.

횡격막탈장(橫隔膜脫臟) 및 횡격막이완증(橫隔膜弛緩症) -10례(例) 보고-

최수승,이정호,유영선,유회성,Choi, S.S.,Lee, J.H.,Yoo, Y.S.,Yu, H.S. 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

This case report included 4 cases of traumatic diaphragmatic hernias, 3 cases of non-traumatic diaphragmatic hernias, and 3 cases of eventration of the diaphragm. Among the traumatic hernias, one case was in immediate phase of traumatic diaphragmatic rupture by traffic accident, 2 cases were in intermediate phase with chronic respiratory or vague gastrointestinal symptoms after traffic accident, and the other was developed after an operation, decortication for a chronic empyema with severe pleural calcifications, damaging the diaphragm. Three cases of nontraumatic diaphragmatic hernia were presented, including 2 cases of probable Bochadlek's hernia (Parents refused operation) and a case of Morgagni's hernia with severe gastrointestinal symptoms. And three cases of eventration of the diaphragm with symptoms were also reported. Results of all treated cases were excellent.

식도중복증 1례 보고

허용,이강식,강경훈,유회성,서정일,마성대,Hur, Y.,Lee, K.S.,Kang, K.H.,Yu, H.S.,Suh, J.I.,Ma, S.D. 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.4

Esophageal duplication constitute about 10% of all the mediastinal tumor and relatively rare condition. We have experienced one case of esophageal duplication which was found 2 years previously by radiologic study of chest, as mediastinal mass, in 37 years old male. He had neither clinical manifestations nor physical findings leading to the surgical discovery of the duplication. During the last 2 years, the size k location of the mass were stationary in character. Operative therapy of complete excision performed without surgical complication. On microscopic study, the lining cell of inner wall of cyst. Noted pseudostratified ciliated columnar epithelium with smooth muscle.

Annuloaortic ectasia의 외과적 치험

이섭,안욱수,김병열,이정호,유회성,Lee, S.,Ahn, W.S.,Kim, B.Y.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.1

Between November, 1981 and July, 1989, 4 patients, 3 male and 1 female patients ranging in age from 36 to 45 years, were operated on for aortic insufficiency associated with uncomplicated annuloaortic ectasia. All patients were in New York Heart Association class III. Two patients had clinical stigmata of the Marfan syndrome. The surgical treatment consisted of. supracoronary replacement of ascending aorta with vascular graft and replacement of the aortic valve in our first case. and composite graft replacement of the ascending aorta and aortic valve with reimplantation of the coronary arteries in subsequent 3 cases. Our first patient developed aneurysm of proximal aorta and pseudoaneurysm of distal aortic anastomosis 5 years postoperatively. One patient among the three patients with Ben-tall operation, died of ventricular fibrillation and myocardial failure during immediate postoperative period. Remaining 2 patients were in NYHA class I with follow-up of 16 months and 20 months respectively.

이차공형 심방중격결손증의 외과적 치료;연령에 따른 혈류학적 상관관계에 관한 고찰

이섭,최병철,안욱수,허용,김병열,이정호,유회성,Lee, S.,Choi, B.C.,Ahn, W.S.,Hur, Y.,Kim, B.Y.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.11

Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

낭종성 종격동종양의 임상적 고찰: 11례 보고

허용,이상목,이섭,유환국,안욱수,김병열,이정호,유회성,Hur, Y.,Lee, S.M.,Lee, S.,Yu, H.K.,Ahn, W.S.,Kim, B.Y.,Lee, J.H.,Yu, H.S 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.10

Congenital cysts of the mediastinum are rare, but interesting lesions. Such cysts are important because they may produce distressing symptoms and because some have a malignant potential. Mediastinal cysts of foregut origin represent an important diagnostic group. Classified according to their anomalous embryonic origins they include pericardial, bronchogenic, esophageal, enteric, and nonspecific cysts. A series of 11 consecutive surgically treated cases from the Dep. of Thoracic & Cardiovascular Surgery in National Medical Center from Oct. 1959 to Dec. 1990, all successfully resolved without mortality. The 8 bronchogenic, 1 enteric, & 2 non specific cysts are included in this series. And 2 of 11 were asymptomatic patients presented. The clinical & pathological behavior of the individual cysts comprise a wide variety of patterns. Proper utilization of the many diagnostic tests available can accurately characterize the cysts. The exact histologic diagnosis, however, is rarely made prior to operation.

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.

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].