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기관 및 기관지 협착 환자에서 자가 팽창성 금속 스텐트 삽입 합병증 수술 치험 2례
홍치욱,박주철,윤엽,Hong, Chi-Uk,Park, Joo-Cheol,Yoon, Yeop 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.2
비록 대부분의 기관지내 결핵 환자들이 약간의 기관지 협착을동반하지만,항결핵제요법과스테로이 드 치료에 잘 반응하지 않는 환자들에서 기관 및 기관지내 개방성을 유지하기 위해서는 더욱 적극적인 치료가 필요하다. 저자가 치험한 첫 번째 경우에는, 기관지내 결핵에 의한 협착이 있는 42세 여자 환자 에게 Modified Gianturco스텐트를 삽입후 육아조직의 증식으로 재협착이 생겨 6cm의 기관절제 및 단단문합술을 시행하였고, 결핵에 의한 좌측 주기관지 협착 증세를 보이는 31세 남자에게 Strecker스텐트 삽입후 스텐트의 이동과 육아조직의 형성으로 재혐착된 예에서는 좌측 주기관지 전체와 하엽을 절제하고 주기관지와 상엽 기관지를 연결하여 주었다. Although most of the patients with endobronchial tuberculosis have some degree of bronchial stenosis, more aggressive treatment is needed to restore the patency of the involved tracheobronchial tree for some patients not responding well to antituberculous chemotherapy combined with steroids. In our first case, we reseated stenotic trachea in a 42 years old women who showe overgrowing granulation tissue through the modified Gianturco steno wire which was previously inserted and anastomosed end to end. Another case was a 37 years old male with left main bronchial rcstenosis complicate, $\boxUl$ after inserting a Strecker stent and sleeve left upper lobectomy was performed.
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홍치욱,조규석,유세영,Hong, Chi-Uk,Jo, Gyu-Seok,Yu, Se-Yeong 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.1
The Increasing use of coronary perfusates for the protection of the human heart during ischemic cardiac arrest has placed great emphasis on the need for a rational and safe formulation. For the purpose of this study isolated rat hearts were connected to retrograde nonworking perfusion system proposed by Langendorff, and then perfused for 20 minutes by coronary infusates of magnesium concentration of 1.66 m Mol per liter(group A, n: 10) or 15mMo1 per liter(group B, n: 10). After 20 minutes perfusion, cold cardioplegic solution (modified St. Thomas'Hospital solution) was infused for 2 minutes, and prepared within 4$^{\circ}C$ Krebs-Henseleit solution. Finally, 20 minutes of cononay reprsfuslon was reestablished after I hour of cold ischemic cardiac arrest. Hemodynamic parameters (heart rate, left ventricular pressure, $\pm$ dp/dt max. and coronany flow) and enzymes assay (creatine phosphokinase, lactic dehydrogenase and flutamic oxaloacetic transaminase) were performed each other at whic rat heart was perfused for 20 minutes and reperfused for 20 minutes thereafter. There were significant differences in the recovery rate of heart rate, systolic left ventricular pressure, + dp/dt max, and coronary flow and reperfusion-perfusion ratio of creatine phosphokinase(P < 0.05). But, there were no signicant differences in the recovery rate of dp/dt max, and reperfunion-perfusion ratio of lactic dehydrogenase and glutamic oxaloacetic acid (P > 0.05).
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홍치욱,박주철 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.1
1986년 1월부터 1995년 12월까지 24예의 흉선종에 대한 수술적 치료를 시행하였다. 대상환자들은 남자 17명, 여자 7명이었으며, 연령은 23세 에서 69세 사이였다. 중증근무력증은 14예에서 동반되 있다. 조직학적 분류로 임파구성 12예,흔합형 8예,상피세포형 4예를 보였고, 병기학적 분류로 I기 11예, II기 4 예, III기 8예였고 VI기는 1예 있었다. 11예의 비침윤형은 모두 외과적 절제를 하였고, 침윤형 13예중 10예에서 완전절제가 가능하였고, 나머지 3예는 부분절제 또는 조직생검후 방사선치료 및 항암화학요법을 시행하였다. 25일에서 60개월의 추적 조사기간중 사망이 3예 있었고, 경과의 호전 4예, 재발 2예 및 15예의 완쾌를 관찰하였다. 근무력증을 동반한 흉선종 환자 14예중 1예가 근무력위기로 사망하였고, 2예가 증상악화, 6예가 약 용량을 감소 또는 복용을 중지하였으며 5예는 술전과 비슷한 용량의 약물치료가 필요하였다 Between January 1986 and December 1995, 24 patients were treated surgically for thymoma. There were 17 males and 7 females, and their ages ranged from 23 to 69 years old and mean age was 49 years. Thymomas ere associated with fourteen myasthenia gravid, and classified histologically as Iymphocytic in 12 patients, mixed in 8, epithelial in 4, and classified clinically as stage I in 11, stage II in 4, stage III in 8 and stage VI in 1 patient. Eleven patients with non-invasive thymoma had received surgical resection, and 10 out of 13 patients with invasive thymoma were able to undergo complete resection. A partial resection or tissue biopsy followed by radiation or chemotherapy was done with the remaining three patients. Three died, four had improvement of symptom, two had relapse and fifteen had no symptom during follow up ranged from 25 days to 60 months. In fourteen cases of thymoma with myasthenia gravid, one died due to myasthenic crisis, two showed symptom aggravation, six had less medical treatment and five patients had medical treatment as same as dosage received preoperatively.
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종골 고립성 골 낭포의 내시경적 소파술 및 골이식 치료
구본섭,김경철,최재열,정화재,신헌규,홍치욱,Koo, Bon-Seop,Kim, Kyung-Chul,Choi, Jae-Yeul,Jeong, Hwa-Jae,Shin, Hun-Kyu,Hong, Chi-Uk 대한족부족관절학회 2001 대한족부족관절학회지 Vol.5 No.1
Purpose: The purpose of this study is to report the result of endoscopic assisted curettage and bone graft for the treatment of simple bone cyst in the calcaneus. Materials and Methods: Three cases in three patients who had curettage and bone graft of simple bone cyst in the calcaneus under endoscopic view were prospectively reviewed. A minimum follow-up of 1 year was required for entrance into the study. The results of treatment were clinically and radiologically assessed. Results: One case with preoperative heel pain gained complete relief of the pain at postoperative four weeks. All three cases had radiological union of grafted bone at an average of thirteen weeks after the operation. Shortened hospitalization and decreased postoperative pain were remarkable. Complications such as infection, skin necrosis, nerve injury, and, fracture were not seen. There was no evidence of the recurrence of the cyst in all three cases. Conclusion: Endoscopic assisted curettage and bone graft of simple bone cyst in the calcaneus is thought as an effective alternative procedure avoiding the possible complications of the classic method.
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