농흉의 임상적 고찰 (제 1보)

유회성 대한흉부심장혈관외과학회 1971 Journal of Chest Surgery (J Chest Surg) Vol.4 No.2

The incidence of empyema has been drastically reduced with the advent of antimicrobial drugs,however,there is still complicated and difficult problems of management of empyema remaining. During the period of December, 1958 to December, 1962, 90 patients nf empyema thoracis were managed in the Department of Thoracic Surgery of the National Medical Center, and this series deals with the incidence,etiologic consideration, bacteriology and management of empyema with its result. 1] Male predominates with the ratio of 3.1: 1, and peak age incidence lies in 3rd decade. 2] Most common etiologic factor is bronchorespiratory infection among which tuberculosis remains highest incidence. 3] 56.7% of patients shows positive result of bacteriologic study and about half of positive culture series shows mixed infection or changing pattern of bacteriological strains during serial examinations. 4] Complete cure is obtained in 84.4% of patients with 5 deaths.

성인 전폐정맥 연결이상 [TAPVR] 교정 1례 보고

유회성 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.2

This 18 year old girl with total anomalous venous connection, which was corrected surgically for the first time in Korea, is presented here. This patient has mild cyanosis, ejection systolic murmur with splitting of $S_2$ ,identical $O_2$ saturation of bleed samples from right and left chambers of the heart. The type was supracardiac TAPVC. On conventional cardiopulmonary by pass was used, and an right sided approach was employed. Post-op. course was smooth except for transient arrhythmia, low blood pressure and jaundice. She left hospital in a good general conditions.

식도 Achalasia 에 대한 재수

유회성,남충희,박국양,Yu, Hoe-Seong,Nam, Chung-Hui,Park, Guk-Yang 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.4

The modified Hellers myotomy for esophageal achalasia is known as the best procedure. A properly performed transthoracic esophagomyotomy is essential to prevent complications. But it has some problems such as persistent achalasia due to inadequate myotomy, recurrence due to the healing of myotomy and reflux esophagitis due to destruction of the lower esophageal sphincter. The methods of the reoperation after esophagomyotomy for achalasia of the esophagus consist of 1 ] for persistent achalasia due to inadequate myotomy, additional myotomy feasible. 2] for esophageal reflux, a long-limb jejunal gastric drainage after vagotomy and hemigastrectomy, jejunal after conservative resection for stricture. We experienced 3 cases of reoperation after esophagomyotomy for achalasia of the esophagus. The 1st and 3rd case belongs to 30 cases which were undertaken the primary operation at the National Medical Center from 1961 to 1984. The 2nd case was undertaken the primary operation at other hospital. The 1st and 3rd case were reoperated because of persistent achalasia due to inadequate myotomy and 2rid case was caused by stricture due to reflux esophagitis. The methods of the reoperation were additional myotomy in 1st case, esophagogastrectomy and lower thoracic esophagogastrostomy in 2nd case, and esophagogastrectomy and mid-thoracic esophagogastrostomy in 3rd case. All three cases were complicated with postoperative reflux esophagitis.

외과적 치료를 가한 광범위 흉복부 대동맥류 1례

유회성,유원하 대한흉부심장혈관외과학회 1970 Journal of Chest Surgery (J Chest Surg) Vol.3 No.2

A Case of thoraco-abdominal aortic aneurysm involving from the lower descending- thoracic aorta to bifurcation of abdominal aorta into both common iliac artery is presented in special view-point of its surgical technic and postoperative complication. Operative technic is the most popular method of Dr. De Bakey's shunt of Dacron which is bridging thoracic aorta to terminal abdominal aorta primarily as temporary shunt but after anastomosing the individual hranch of left Renal, Celiac, Sup. meseateric and right Renal artery to corresponding part of the Dacron tube, the Dacroa graft is fixed as permanent graft in stead of excised thoraco-abdominal aorta. The patient died of acute renal failure and increasing evidence of CNS damage due to respiratory acidosis on 6th postoperative day hut this report will he a good experience in respect of further progress of aortic surgery in Korea.

심혈관질환 수술에 대한 임상적 고찰

유회성 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.3

From 1959 to Jun. 30 84, 1144 cases of various cardiovascular diseases were operated consisting of 421 open heart surgery under extra-corporeal circulation or hypothermia and 723 conventional surgery at department of Thoracic and Cardiovascular Surgery in National Medical Center. There were 470 congenital anomaly and 674 acquired lesions. Out of 470 congenital anomaly, acyanotic anomaly was 289 and cyanotic anomaly was 181. Among 647 acquired lesions, 473 was cardiac lesion, 87 was pericardial lesion and 105 was vascular diseases. Over all operative mortality was 9.0%, consisting of 7.6% for acyanotic, 19.3% for cyanotic anomaly and 6.8% for acquired lesion. Mortality for 723 conventional surgery was 6.2%, and 421 open heart surgery was 13.8%.

식도암의 외과적 치료후 합병증 및 사망률에 대한 고찰

유회성 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.2

Between June 1, 1971 and June 31, 1983, 90 patients of esophageal carcinoma were experienced at N.M.C. Surgery was applied to 63 patients [70%]; Exploratory operations, including feeding gastrostomy, feeding jejunostomy, & esophagecutenostomy with feeding gastrostomy, was done in 26 patients due to advanced stage or general condition. Esophagogastrectomy [or esophagectomy] with esophagogastrostomy was done in 25 patients, curative operation in 9 patients & palliative operation in 16 patients. Colon bypass in 12 patients, 7 cases with tumor resection & 5 cases without resection. Postoperative complications were anastomotic leakage [14.3%], respiratory complications [19.1%], & others. Anastomotic leakage & respiratory complications were major fatal complication in surgery of esophageal carcinoma. Postoperative mortality was mainly due to respiratory complications [14.3%] & anastomotic leakage [7.9%].

폐 Aspergillosis 의 외과적 치료

유회성 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.2

Since tuberculosis was a common pulmonary disease in Korea, Aspergillosis was easily misdiagnosed as tuberculosis and an acute form of Aspergillosis was misinterpreted as pneumonia because of their similarities in the X-ray findings. This investigation is designed to illustrate the clinical features and preoperative diagnosis and surgical role in the management of this disease. In a retrospective review of operative cases from Jan. 1963 through Dec. 1983, 36 cases were analyzed. Peak age incidence lies in the 3rd decade [41.7%]. All cases had a history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis and the most common chief complaint was hemoptysis [69.5%]. Only nine cases [25%] showed cavitary lesions with mycetoma and preoperative sputum study for fungus showed low positive valve [42.3%]. Anatomical location of lesion was located mainly upper lobe [66.7%] and most of cases were managed by lobectomy. We experienced 7 cases of complication; they were postoperative empyema, hepatic failure, esophageal varix bleeding. Postoperative pathologic findings showed that 29 cases [80.5%] were combined with tuberculosis 3 cases were combined with bronchiectasis and 4 cases were not combined with other disease. In conclusion, when the patient has a longstanding history of pulmonary tuberculosis and has a hemoptysis, he must be suspected fungus super infection. Resectional surgery is the treatment of choice for symptomatic localized disease and needed resection in asymptomatic patient to prevent possible fatal sequelae in the future.

종격동 종양의 임상적 고찰 -110례 임상 경험-

유회성 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.4

Mediastinal tumors have long fascinated the thoracic surgeon because of their variety and unpredictability of diagnosis prior to exploration. We report the analysis of the 110 cases of mediastinal tumors, experienced in the dept. of the thoracic and cardiovascular surgery of the National Medical Center from December 1959 to August 1983. The age distribution was relatively even and the mean age was 37 years old. The germ cell tumors were 29 cases [31%], the neurogenic tumors were 19 cases [20%], the thymomas were 16 cases [17%], the lymphomas were 8 cases [8.5%], the primary or secondary carcinomas were 11 cases [12%], the bronchogenic and the P.W cysts were 4 cases, the mesenchymal tumors were 3 cases, the TB gangliomas were 3 cases among the 94 cases, histologically analysed. The malignant tumors were 39 cases [41%]. In classified by histological types, the tumor size, location and the clinical manifestations are presented. The successful removal was done in 53 cases [96%] among 55 cases of benign mediastinal tumors. In 39 malignant cases, the surgical intervention had been done in 21 cases [54%], and inoperable cases were 16 [41%], and the operative deaths were 2 cases [5%].

이차공형 심방중격결손증의 외과적 교정

유회성 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.4

승모판막증의 외과적 치료생체판을 이용한 판치환 : 생체판을 사용한 변치환술

유회성 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.4

Between Jan. and Oct. 1978, mitral valve Replacement had been performed on eight patients using porcine aortic valve mounted on flexible polypropylene or Egyloil wire and Dacron covered stent. Mitral valve replacement was performed on five, mitral valve replacement with tricuspid valve replacement on two, and mitral valve replacement with tricuspid valve annuloplasty on 1 patient using five Carpentier and five Hancock Xenograft. Overall operative deaths were 2 cases. All other 6 cases did well after surgery and improved. No systemic thromboembolism occurred without anticoagulant-No valve failure took place. The results are satisfactory.