자연성 인두천공에 의한 급성하행 괴사성 종격동염 -1례 보고-

조규도,박찬범,조덕곤,김치경,왕영필,곽문섭 대한흉부외과학회 2002 Journal of Chest Surgery (J Chest Surg) Vol.35 No.11

Acute Descending Necrotizing Mediastinitis Secondary to Spontaneous Rupture of Hypopharynx-A Case Report- 하행 괴사성 종격동염은 치원성 및 구강인두 감염증의 합병증으로 발병되며 높은 사망률을 보이는 질환이다. 자연성 인두천공이 원인이 되어 발생한 급성 하행 괴사성 종격동염은 국내에서 보고된 바 없으며 영어로 발표된 문헌들을 조사해서도 한 증례만 검색할 수 있었다. 본 증례의 치료과정 중 종격동내의 배농관이 정확하게 위치되어서 효과적인 배농술이 이루어져야 환자의 생존률을 높이는데 도움이 되리라고 생각되었다.가톨릭 대학교 의과대학 흉부외과학 교실에서는 자연성 하인두 천공에 의해 발생한 급성 하행 괴사성 종격동염의 증례를 치험하였기에 보고하는 바이다.

청색증을 동반한 다발성 폐동정맥루 치험 1례

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

Pulmonary arteriovenous fistula is a rare congenital vascular malformation in the lung, resulting from erroneous capillary development, with incomplete formation or disintegration of the vascular septa that would normally divide the primitive connection between the venous and arterial plexus. The pathogenesis of its symptom is that unoxygenated and desaturated arterial blood enter into the pulmonary venous system directly. Recently we have experienced a case of multiple pulmonary arteriovenous fistula in a 15 year old male patient, who presented the symptom of cyanosis and dyspnea on exertion. The operation revealed well circumscribed and multilobulated aneurysmal lesion in left lower lobe with its subpleural and posterolateral basal location, and another aneurysmal lesion in inferior lingular segment of left lung. There was no abnormal connection between the fistula and systemic circulation. The left lower lobectomy was performed along with local extirpation of the inferior lingular segment of left lung. Both lesions showed angiomatous dilatation of the various sized vessels embedded in the parenchyma microscopically. Postoperative clinical course disclosed much improvement in symptoms and in the value of blood gas analysis. The patient was discharged without any complication.

천둥번개(雷)로부터 전력(電力) 및 통신(通信) 시설을 방호(防護)하는 대책에 대하여

조규심(曺圭心) 대한전기학회 1996 전기의 세계 Vol.45 No.7

眞空管(또는 전자관)의 興亡盛衰와 最近의 動向

조규심(曺圭心) 대한전기학회 1997 전기의 세계 Vol.46 No.1

비행기(飛行機)나 선박(船舶)은 여하(如何)히 낙뢰(落雷)를 피(避)하는가에 대한 궁리(窮理)

조규심(曺圭心) 대한전기학회 1997 전기의 세계 Vol.46 No.10

전기 및 전자공학에 관계되는 신소재의 발전

조규심(曺圭心) 대한전기학회 1997 전기의 세계 Vol.46 No.5

체외순환을 이용한 T4 폐암의 수술적 치험 -장기 생존 1예 보고-

조규도,조민섭,윤정섭,김치경,곽문섭 대한흉부외과학회 2004 Journal of Chest Surgery (J Chest Surg) Vol.37 No.2

We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1M0). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival. 우폐하엽의 폐암이 심낭과 좌심방의 하폐정맥 유입구를 침범한 62세 남자 환자에서 심폐체외순환을 이용하여 우폐 중하엽절제술을 시행하였다. 환자는 수술 후 제2일째에 우폐상엽의 국한성 폐부종이 발생하였으며 폐부종이 치료된 후 우폐의 기관지늑막루가 발생하였다. 유경대망을 이용하여 기관지늑막루를 봉합하였다. 그 후의 임상 경과는 양호하였으며 환자는 현재 6년째 재발 없이 건강히 지내고 있다.

흉부외상 811례 의 임상적 고찰

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

A clinical evaluation was performed on 811 cases of chest trauma who were admitted and treated at the department of thoracic & cardiovascular surgery, Catholic Medical College, during the past 19 years from Jan. 1966 to Dec. 1984. 1. The overall incidence rate of male to female was 3:1. 2. The common age groups were 4th, 5th, and 3rd decades. 3. The most common cause of chest trauma was stab in penetrating wound and traffic accidents in non penetrating wound. 4. The most common injury from non penetrating chest trauma was rib fracture [81.3%], and the incidence rate of flail chest was 14.5% of all cases of rib fractures. 5. The incidence rate of hemo-pneumothorax was 50.4% in non penetrating wounds, and 55.2% in penetrating wounds. 6. The most common method of surgical treatment was CTD [33.5%], and open thoracotomy was performed in 67 cases [8.3%]. 7, The overall mortality was 3.3% [27 cases], and common causes of the death were shock and respiratory insufficiency.

개심술을 시행하는 환자에서 경식도 심초음파의 이용

조규도,김치경 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.12

가톨릭대학교 의과대학 부속 성바오로 병원에서 1996년 1월부터 7월까지 개심술시 경식도심초음파를 이용하여 수술 중 관찰한 61명의 증례를 분석하여 다음과 같은 결과를 얻었다. 61명의 환자 중 질병 분류는 심장 판막 질환 25명, 관상동맥 질환 22명, 선천성 심질환 13명, 심장 판막 질환과 관상동맥 질환이 병발한 경우가 1명 이었다. 1. 경식도심초음파를 이용하여 선천성 심질환 1예(심실중격결손증 재수술)와 대동맥 판막 치환술을 시행한 환자 1예에서 일차 심정지에 의한 수술 후 잔존 단락과 판막 주위 누출이 확인되어 재심정지를 유도하여 수술을 완료하였다 2. 공기색전증의 발생을 전 예에서 방지할 수 있었다. 3. 경식도심초음파로 측정한 심박출량과 온도희석법으로 측정한 심박출량은 통계학적으로 의미있는 상관관계를 보여 경식도 초음파를 이용한 심박출량 감시가 의미 있음을 시사하였다(Linear regression analysis, p<0.001). 4. 관상동맥우회로술을 시행한 23명의 환자에서 수술 중 경식도 초음파도상 이상 벽운동을 보이는 분절의 도부타민 투여 전후와 관상동맥우회로술 후의 반응을 비교 관찰하였다. 저 용량 도부타민 검사는 통계적으 \ulcorner유의하였다(민감도 76%, 특이도 94.7%, 양성 예측율 95%, 음성 예측율 75%). This study reviewed useful aspects of the intraoperative transesophageal echocardiography among the patients in whom heart surgery were undertaken between January 1996 and July 1996 at St.Pauls hospital, Medical College of Catholic University, Seoul, Korea. During that period, 61 patients were operated on because of valvular heart disease(25 patients), coronary artery disease(22 patients), congenital heart disease(13 patients), and combined coronary artery disease and valvular heart disease(1 patient). Two patients(1 redo-VSD and 1 valvular heart diease) needed repeated aortic cross clamping and complementary procedures because of incomplete initial procedures. There was no incidence of air embolism. We could observe significant relationship of cardiac output monitoring methods either by thermodilution technique and transesophageal echocardiography by linear regression analysis(p<0.001). We tested myocardial response(percentage of systolic wall thickness, PSWT) with low dose dobutamine challenge to predict post-CABG myocardial perfusion. And the test showed statistically significant resp.onse(sensitivity 76%, specificity 94.7%, positive predictive value 95%, negative predictive value 75%). These results suggest that cardiac surgeon could draw more benefits by intraoperative transesophageal echocardiography.

좌심방 점액종 2례 보고

조규도,김세화,Jo, Gyu-Do,Kim, Se-Hwa 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.4

The primary cardiac tumor was considered as a form of disease with poor prognosis in the past and it was hardly diagnosed before post mortem autopsy. But recent development of diagnostic procedure and the cardiac surgery using extracorporeal circulation increased the accuracy of diagnosis and the opportunity of successful treatment. The authors present two cases of left atrial myxoma which experienced during recent 4 years between 1979 and 1982. A 33 year old woman admitted with severe shortness of breath, generalized edema, ascites and the evidence of hepatopathy resulted from right sided heart failure. Preoperatively, the patient was treated with conservative medication to improve general condition for a few days. The tumor mass was removed successfully under the cardiopulmonary bypass. She, however, died of myocardial dysfunction showing low blood pressure. The tumor mass weighed 22gm and measured 5.2x4.5x3.6 cm in size. A 60 year old man admitted with shortness of breath on exertion and an episode of fainting. Following the removal of tumor mass under the cardiovascular bypass, the clinical course was satisfactory with no complication. The tumor mass weighed 105gm and measured 9x4x5 cm in size.