늑막 중피세포종: 6례 보

권오춘 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.4

Mesothelioma is relatively uncommon tumor compared to other thoracic tumors. It is interesting that there is a strong relationship between occurrence of malignant mesothelioma and exposure to asbestos, which was established during the last two decades. Malignant mesothelioma is discouraging in viewing its treatments and survival rates. Surgery with ancillary treatment, such as radiotherapy and chemotherapy, were still palliative, although encouraging results were reported. Between 1958 to 1983 at NMC, we have been experienced 6 cases of mesothelioma, confirmed by pathohistologic findings. The patients were distributed between 19 to 52 y-o age & were 5 males and 1 female. There was evidence of exposure to asbestos in 1 case. The method of operation were decortication [1], decortication with removal of tumor [1], pleuropneumonectomy with chemotherapy [1], chemotherapy [1], exploratory thoracotomy [1], and no treatment in 1 case due to private affairs. Histologic findings were 2 cases of benign mesothelioma type.

소아개심술 후 시행한 순환보조장치의 임상적 고찰

권오춘,이영탁 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.5

Background: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. Material and Method: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5$\pm$3.5 years). Result: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0$\pm$23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. Conclusion: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.

인공심방판막실패에 대한 임상적 고찰

권오춘 대한흉부심장혈관외과학회 1986 Journal of Chest Surgery (J Chest Surg) Vol.19 No.4

Despite the multivariate improvements in tissue treatment, material, and design of prosthetic heart valves in recent years, numerous complications that may lead to valve dysfunction remain a constant threat after valve replacement. Most common indications for prosthetic valve failure are primary valve failure, infective endocarditis, paravalvular leakage, and thromboembolism. From 1977 to 1986, 15 patients underwent reoperation for prosthetic valve failure in 278 cases of valve surgery. The etiology of prosthetic valve failure were primary valve failure in 12 patients [80 %], infective endocarditis in 2 patients [13.3 %], and a paravalvular leakage [6.7 %]. The average durations of implantation were 45.5 months; 53.9 months in primary valve failure, 16 months in infective endocarditis, and 4 months in paravalvular leakage. The rate of valve failure was high under age of 30 [11/15]. Calcifications and collagen disruption of prosthesis were main cause of primary valve failure in macro- & micropathology. Prosthesis used in reoperation were 5 tissue valves and 10 mechanical valves. Operative mortality were 13.3 % [2/15], due to intractable endocarditis and ventricular arrhythmia.

Primary Repair of Truncus Arteriosus with Aortic Homograft : Report of Two Cases

권오춘 최신의학사 2002 最新醫學 Vol.45 No.1

Pulmonary Carcinosarcoma within Bronchogenic Cyst: 1례 보고

권오춘 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.2

Carcinosarcoma is an unusual and rarest neoplasm in man, consisting of carcinomatous parenchyme and sarcomatous stroma. Two clinical types of carcinosarcoma were present. One type of tumor was centrally located [endobronchial type], infrequent metastasis, and better prognosis than parenchymal type. The other type was peripherally located [parenchymal type], frequent metastasis, and poor prognosis. The histogenesis of carcinosarcoma is many hypothesis, but controversial; 1] sarcomatous degeneration of stroma, 2] intermingling of simultaneously arising carcinoma & sarcoma, 3] multiple primary tumor, 4] blastomatous changes in hamartoma, 5] stromal reaction to squamous cell carcinoma, 6] true & collision carcinosarcoma. In this case, 52 year-old male patient was hospitalized due to intermittent hemoptysis & known pulmonary lesions. Since 1968, chest PA showed round haziness within cyst & multiple cyst on RUL & RLL. Radical pneumonectomy was performed and histopathology showed carcinosarcoma, surrounded by bronchial epithelium. The patient maintain general well-being without clinical evidence of recurrence till now.

소 대동맥 판막륜을 가진 대동맥판막 협착증 치험 1례 보고

권오춘 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.4

Whatever a surgeon choose aortic prosthesis in aortic stenosis, it will always provoke some degree of obstruction to flow due to its smaller effective orifice area to tissue annulus. Occasionally, we meet small aortic annulus to his or her body surface area in aortic valve replacement. The small annulus remains a problem in that both tissue and mechanical prosthesis have significant pressure gradients between LV and aorta in resting or exercising states. In these circumstances, diverse surgical procedures, such as tilting disc prosthesis, supraannular position of aortic prosthesis, and enlargement of aortic root [including aortoventriculoplasty, translocation of aortic valve, & double outlet of LV by valved conduit], were applied. We experienced one case of aortic stenosis with small aortic annulus. Systolic pressure gradients between LV & aorta were 90 mmHg. Diameter of annulus was 19 mm. So we performed patch enlargement of aortic root by Manouguian and AVR with St. Jude medical valve 23 mm.

비디오 흉강경을 이용한 자연기흉의 수술요법

권오춘,안욱수 대구효성가톨릭 대학교 1997 연구논문집 Vol.54 No.2

Primary spontaneous pneumothorax has an annual incidence of 9 cases per 100,000 populations, especially high incidence in young adults. Thoracoscopic surgery is not new, but its applications to chest surgery have been more increasing with advanced video technology and instrumentation. We performed 15 cases of bullectomy using video-assisted thoracoscopy(VATS) for patients of pneumothorax. The mean age of patients was 25.1±7.6 years old, 105.5±40.1 minutes of mean operation times, and 3.2±1.9 days of postoperative tube indwelling time. Postoperative complications were persistent air leakage in one case, which was converted to open thoracotomy later, and recurrence of pneumothotax in one case. Video-assisted thoracoscopic bullectomy is effective alternative to thoracotomy for treatment of pneumothorax in terms of short hospital stay, less morbidity, low rate of recurrence, less pain, and good cosmetic results. But objective comparison with mini-thoracotomy will be needed in many aspects.

Severe Mitral Regurgitation due to Traumatic Anterolateral Papillary Muscle Rupture: A Case Report

이철호,권오춘,이섭,장재석 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.6

A 29-year-old man was admitted for abrupt dyspnea and hemoptysis. An echocardiogram revealed severe mitral regurgitation due to papillary muscle rupture for which an emergency mitral valve replacement operation was performed 4 days after admission. Herein, we report our experience with this case along with a review of the literature.

Cystic Mass on Right Atrium of Unusual Form of Chiari’s Network: A Case Report

배지훈,권오춘,이섭,이철호,조준우 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.4

Chiari's networks are present in 1.5% to 4% of the population. They are a congenital disease characterized by a remnant of the right valve of sinus venosus and rarely have clinical significance. Chiari’s network, as the name implies, has network-like shape, but there are other forms of appearance. We have experienced a case of a 60-year-old woman who had a cystic mass on the right atrium. Surgical treatment was performed forthe mass removal and differential diagnosis of the mass. There was no evidence of other tumor, but Chiari’s network. As cystic form of Chiari's network have not been reported before, it is the first report of cystic form of Chiari’s network.

Traumatic Aortic Injury: Single-center Comparison of Open versus Endovascular Repair

조준우,권오춘,이섭,장재석 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.6

Background: Conventional open repair is a suboptimal therapy for blunt traumatic aortic injury (BTAI) due to the high postoperative mortality and morbidity rates. Recent advances in the thoracic endovascular repair technique may improve outcomes so that it becomes an attractive therapeutic option. Materials and Methods: From August 2003 to March 2012, 21 patients (mean age, 45.81 years) with BTAI were admitted to our institution. Of these, 18 cases (open repair in 11 patients and endovascular repair in 7 patients) were retrospectively reviewed and the early perioperative results of the two groups were compared. Results: Although not statistically significant, there was a trend toward the reduction of mortality in the endovascular repair group (18.2% vs. 0%). There were no cases of paraplegia or endoleak. Statistically significant reductions in heparin dosage, blood loss, and transfusion amounts during the operations and in procedure duration were observed. Conclusion: Compared with open repair, endovascular repair can be performed with favorable mortality and morbidity rates. However, relatively younger patients who have acute aortic arch angulation and a small aortic diameter may be a therapeutic challenge. Improvements in graft design, delivery sheaths, and graft durability are the cornerstone of successful endovascular repair.