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노인성 자연 기흉의 치료방법 및 그 결과;50세 이상환자 60례 대상
조선환 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.7
To assess the therapy of spontaneous pneumothorax in the aged patients, the treatment methods and results in 60 patients 50 years of age or older were retrospectively reviewed. Most of the patients were male [56 of 60 patients] and the major underlying lung diseases associated with spontaneous pneumothorax were tuberculosis [32 patients] and chronic obstructive lung disease [20 patients]. The recurrence rate of thoracostomy tube drainage with or without chemical pleurodesis using tetracycline was 39.6% [21 of 53 patients], but there was no recurrence in the patients treated with open thoracotomy, pleural abrasion, and chemical pleurodesis using talcum powder[Asbestosis free]. In the patients treated with open thoracotomy, the bullous or bleb lesions were placed in the various sites of both lungs. We concluded that even though thoracostomy tube drainage is the first choice of therapy for spontaneous pneumothorax in the aged patients, the recurrence rate is high, especially in the patients with persistent air leakage for more than 2 days, and the open thoracotomy with pleural abrasion and chemical pleurodesis using talcum powder can prevent the recurrence in the selected patients.
최종범,조선환,Choe, Jong-Beom,Jo, Seon-Hwan 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.3
Twenty-four patients with left main coronary artery stenosis exceeding 50% underwent coronary artery bypass grafting from January 1991 through June 1993. Four patients [17%] had stenosis only in left main coronary artery and 20 patients [83%] had associate lesion[s] in left anterior descending , circumflex, or right coronary artery. Sixteen patients [67%] had higher degrees of stenosis [>70%] in left main coronary artery. Preoperatively 18 patients [75%] had unstable angina pectoris even during aggressive medical treatment. Preoperatively aggressive medical treatment was performed to relieve the symptom in patients with unstable angina. All patients were perioperatively treated with continuous infusion of isosorbide dinitrate to stabilize symptomatic and hemodynamic states. Twenty patients underwent elective coronary bypass surgery and 4 patients urgent operations due to severe unstable angina. There was no thirty-day mortality or late death. Angina recurred in 1 patient, but coronary angiographic study showed good patency of grafts and the symptom was relieved with medical treatment. We concluded that coronary artery bypass grafting can be safely performed by perioperative efforts, including continuous infusion of isosorbide dinitrate, for hemodynamic stabilization in patients with left main coronary artery stenosis.
근육편에 의한 정중 흉골절개 감염의 치료 -5례 치험-
김형곤,조선환,최종범,Kim, Hyeong-Gon,Jo, Seon-Hwan,Choe, Jong-Beom 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.7
Infection of a median sternotomy incision may result in a large, unsightly,unstable,and potentially fatal wound. During the past 8 years, 5 consecutive patients [ 4 male and 1 female ] had repair of infected sternotomy wound. We describe our current preferred techniques and the results we have achieved with them. As soon as the sternal infection was shown, operative wound was opened and irrigated more than 4 times a day with 0.5% Betadine iodine solution until the exudate became clean with no growth of bacteria. Operation was performed in one-stage, which consisted of aggressive debridement of the infected bone and muscle transposition. Reconstruction was with one-side or both pectoralis flaps in all patients and rectus abdominis in 2 patients. There was no mortality or morbidity within 30 days postoperatively. We conclude that early aggressive debridement and muscle transposition remain the treatment of choice for most patients with infected median sternotomy wounds.
유기수은의 세포독성에 대한 셀레늄의 방어효과에 관한 연구
고대하,염정호,고영상,조선환,오탁순 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.3
The purpose of the present study was to elucidate the cytotoxical influence of mercurial compounds and the protective effect of selenium against mercurial compounds. The effects of mercury compounds and selenium on the syntheses of nitrite(NO₂-) and ATP were observed in the cell cultures of EMT-6 cells and peritoneal macrophages from Balb/c mouse. The viabilities of EMT-6 cells and peritoneal macrophages at the end of culture were significantly decreased in dose-dependent manner by methylmercury chloride(CH₃HgCl) added into the media. NO₂- and ATP syntheses of the cells were dose-dependently inhibited by CH₃HgCl. Simultaneous addition of the equimolar dose of selenium completely prevented mercuryinduced inhibitions of NO₂- and ATP syntheses, which were observed in both of EMT-6 cells and peritoneal macrophages. But these effects of selenium were not appeared in the new medium containing mercurials only which were removed the selenium after the pretreatment of selenium for 6 hours. These results suggest that protective effect of selenium against mercurial compounds was archived by the formation of a complex consisting of Se-Hg or Se-Hg-protein. Though its mechanism was not clear, the protective role of selemium against the mercury toxicity would be exhibited in the immunological system.