우리고장의 자랑 / 읍면정관리를 잘하고 있는 사례 : 빛나는 「 일선행정 」

이정상 대한지방행정공제회 1971 地方行政 Vol.20 No.209

CaNa₂-EDTA 연(鉛) 동원 검사에 의해 확진된 연중독 1 예

이정상,채동완,이건용,전노원,노정우,안규리,김근호 대한내과학회 1996 대한내과학회지 Vol.51 No.6

Recently, cases with lead poisoning due to herb medication with unknown ingredient have been reported increasingly, In general, lead poisoning has been confirmed through estimation of the concentration of lead in serum, of amount of lead excreted in 24 hour urine and so on. But in cases when lead poisoning is suspisious but routine laboratory findings are not compatible with lead poisining, CaNa₂ EDTA mobilization test with determination of excreted amount of lead in 24 hour urine has been known to be an effective method of confirming lead poisoning through determination of chelatable lead stores in the body. Authors experienced one case of suspicious lead poisoning with normal serum leaed concentration, with equivocal results in lead excretion in 24 hour urine collections. Authors confirmed lead poisoning by applying CaNa₂ EDTA mobilization test, for the first time in Korea, to the patient with equivocal laboratory and clinical findings. Here, a case of lead poisoning confirmed by CaNa₂ EDTA mobilization test is presented and recent literatures are reviewed.

갑상선자극 호르몬 분비에 대한 Dopaminergic Control에 관한 연구

이정상,이문호,고창순,김응진,김명덕 대한핵의학회 1978 핵의학 분자영상 Vol.12 No.2

1978년 4월부터 1978년 8월사이에 서울대학교병원 내과에 내원하였던 원발성 갑상선기능저하증 환자 9명과 일반신체검사 및 갑상선기능검사상 전혀 이상이 발견되지 않은 의과대학생 6명과 수련의 1명 총 16명을 대상으로 Dopamine 수용체를 선택적으로 차단하는 Metoclopramide와 Dopamine 수용체를 선택적으로 자극하는 Bromergocryptine(CB-154)을 각각 혹은 함께 투여해서 다음과 같은 결과를 얻었다. 1) Metoclopramide(Moxolonⓡ) 10mg을 정맥으로 주사했을때 원발성 갑상선기능저하증 환자들에서는 투여후 20분에 말초혈액에서 갑상선자극호르몬이 통계학적으로 유의하게 증가되었으며, 60분에도 계속 증가되었다. 그 이후 180분까지 계속 증가된 장태를 유대했으며, 중증보다 경증에서 더욱 현저하게 증가되어 나타났다. 그러나 정상인에서는 이러한 증가가 나타나지 않았다. 2) Bromergocryptine(CB-154)을 2mg 경구투여했을때 원발성 갑상선기능저하증 환자들에서는 투여후 120분에 말초혈액에서 갑상선자극호르몬이 현저하게 감소되었고, 240분 및 360분까지 계속 감소되었으며, 중증보다 경증에서 더욱 현저하게 감소되어 나타났다. 그러나 정상인에서는 이러한 감소가 나타나지 않았다. 3) Bromergocryptine(CB-154) 2mg을 경구투여한 후 120분에 Metoclopramide(Moxolonⓡ) 10mg을 정맥 주사했을때 원발성 갑상선기능저하증 환자들에서는 Bromergocryptine을 투여한 후 120분에 말초혈액에서 갑상선자극호르몬이 감소했으며, Metoclopramid를 투여한 후에 약간 증가하는 추세였으나, Metoclopramide를 단독으로 투여했을 때와 같은 현저한 증가는 나타나지 않았으며, 정상인들에서는 Bromergocryptine 및 Metoclopramide를 투여했을때 뚜렷한 증가나 감소는 보이지 않았다. 4) 생리식염수 2ml를 정맥주사했을 때 원발성 갑상선기능저하증 환자들 및 정상인들에서 갑상선자극호르몬이 말초혈액에서 뚜렷한 증가 내지 감소는 보이지 않았다. 5) Metoclopramide와Bromergocryptine을 각각 혹은 함께 투여했을때 및 생리염수를 투여했을 때 혈중 Triiodothyronine 및 Thyroxine치는 각각의 기저치들에 비해 통계학적으로 유의한 증가나 감소를 보이지 않았다. 이상의 결과에서 갑상선자극호르몬의 분비가 Dopaminergic Control을 받는다는 사실을 알 수 있었다. 본 연구를 실시함에 있어 물심양면으로 협조해주신 동아제약에 사의를 표하는 바이다. To e1ucidate the depaminergic control of T.S.H. secretion, we analized the pattern of T.S.H secretion in seven normal controls and nine primary hypothyroid subjects, before and after single or combined administration of specific dopaminergic receptor blocker, metoclopramide, and specific depaminergic receptor stimulant, bromergocryptine (CB-154). The results obtained were as follows: 1) There was a significant rise in T.S.H. levels after intravenous injection of metocioramide(10mg) in hypothyroid subjects. But there was no significant rise in T.S.H. levels in normal controls. The T.S.H. response to metoclopramide varied considerably, being large in mild cases and small in severely hypothyroid subjects. 2) There was a significant fall in T.S.H. levels after oral administration of bromergocryptine(2mg) in hypothyroid subjects, but there was no significant fall in T.S.H. levels in normal controls. 3) There was no significant fluctuation in T.S.H. levels after combined administration of both metoclopramide and bromergocrytine. 4) There was no significant fluctuation in T.S.H. levels after intravenous injection of normal saline(2ml) in both hypothyroid and normal subjects. 5) There was no significant change in serum T3 and T4 after administration of metoclopramide and bromergocryptine respectively and serially. These data support the fact that there is a dopaminergic control in the secretioI1 of T.S.H. in the human.

독성미만성 갑상선종 환자에서 방사성옥소(131I) 투여후 발생하는 영구적 갑상선기능저하증

이정상,이문호,고창순,이홍규,박선양 대한핵의학회 1977 핵의학 분자영상 Vol.11 No.1

저자들은 방사성옥소투여후에 발생하는 갑상선기능저하증의 발생상황을 알아보기 위하여 1960년부터 1977년까지 서울대학교 의과대학 부속병원 내과 방사성동위원소진료실에서 131I 치료를 받은 독성미만성 갑상선종환자 794명을 대상으로 단회투여군과 다회투여군, 소량투여군과 다량투여군, 그리고 연령군별 및 안구돌출유무에 따른 갑상선기능저하증의 발생빈도를 조사하여 다음과 같은 결과를 얻었다. 1) 631명의 방사성옥소 단회투여군에서는 갑상선기능저하증의 발생빈도가 치료후 1년에 7.4%, 2년에 11.8%, 3년에 16.2%, 4년에 22.1% 그리고 5년에는 25.5%였으며, 163명의 다회투여군에서는 1년에 8.6%, 2년에 10.4%, 3년에 13.3%, 4년에 29.1% 및 5년에는 54.1%로 양군에서 모두 시간이 경과함에 따라 증가하였으며 4년 이후에는 다량투여군에서 그 발생빈도가 급격히 증가하였다. 2) 5mCi 이하의 131I를 1회만 투여받아 평균 4.3±0.6mCi의 131I 치료를 받은 550명의 소량투여군에서의 갑상선기능저하증의 발생빈도는 치료후 1년에 6.8%, 2년에 11.4%, 3년에 15.4%인 반면, 5.5mCi 이상의 131I 투여를 받아 평균 6.3±0.5mCi의 131I 치료를 받은 다량투여군환자 81명에서는 1년에 12.0%, 2년에 15.4% 그리고 3년에 20.4%로 다량투여군에서 발생빈도가 높은 것을 알 수 있었다. 그러나 방사성옥소 치료후 정상 갑상선기능상태로 되는 기간은 소량투여군과 다량투여군에서 각각 평균 5.1±3.6개월 및 4.8±2.8개월로 양군간에 통계학적으로 유의한 차이가 없었다(p$gt;0.1). 3) 방사성옥소 단회소량투여군환자 550명을 대상으로 조사한 연령군별 갑상선기능저하증의 발생빈도는 30세미만의 환자에서는 1년에 4.3%, 2년에 7.7%, 30세에서 49세까지의 환자들에서는 1년에 5.8%, 2년에 11.1% 그리고 50세 이상의 환자들에서는 1년에 11.0%, 2년에 14.4%로 연령이 많을수록 증가하는 경향을 보였다. 4) 역시 방사성옥소 단회소량 투여군환자 300명을 대상으로 조사한 안구돌출유뮤에 따른 갑상선기능저하증의 발생빈도는 치료후 1년과 2년에 각각 안구돌출이 있는 환자들에서는 7.1% 및 12.1%, 그리고 없는 환자에서는 7.3% 및 12.2%로 양군간에 차이가 없었다. 이상에서 저자들은 독성미만성 갑상선종환자에서 방사성옥소 치료후 발생하는 갑상선기능저하증은 과거 국내에서 보고된 것보다 그 발생빈도가 높으며 시간이 경과함에 따라 증가하고, 특히 다회투여군에서는 치료후 4년 이후에 연증가율이 급격에 증가하며, 초회치료로 호전되는 환자에서는 방사성옥소투여량을 줄임으로써 그 발생빈도를 감소시킬 수 있음을 관찰하였다. Radioactive ioine(RAI), principally 131I, effectively controls hyperthyroidism in the majority of patients. The subsequent development of hypothyroidism, however, has been of increasing concern since it was first pointed out by Chapman and Maloof in 1955. And the steady increase of late hypothyroidism during the passage of time was known with its relation with dosage of RAI. The authors have investigated the development of hypothyroidism in 935 patients with diffuse toxic goiter(DTG) who were treated with RAI(131I) at the Seoul National University Hospital from 1960 to 1977 to reveal its relation with the number of RAI treatments, dosage of RAI, age of patients and exophthalmos with the following results. 1)The incidence of hypothyroidism by year after RAI therapy among 631 patients with DTG who were treated with single RAI regimen was 7.4%(1 year), 11.8%(2 year), 16.2%(3 year), 22.1%(4 year) and 25.5%(5 year), and that anong 163 patients given multipie RAI treatments was 8.6%(1 year), 10.4%(2 year), 13.3%(3 year), 29.1%(4 year), and 54.1%(5 year) respectively showing much higher yearly increments from 4 years after RAI treatmenet in comparison with the former. 2) Among 550 patients in the lower dose group treated with single RAI regimen less than 5.0mCi(Mean±S.D.: 4.3±0.6mCi), the incidence of hypothyroidism by year after RAI treatment was 6.8%(1 year), 11.4%(2 year), 15.4%(3 year), while among 81 patients in the higher dose group given single RAI treatment not less than 5.5mCi (Mean±S.D.: 6.3±0.5mCi) it was 12.0%(1 year), 15.4%(2 year) and 20.4%(3 year) respectively. However, the duration till euthyroid state after RAI therapy in the two groups was 5.1±3.6 months and 4.8±2.8 months respectively showing no statistically signficant difference (p$gt;0.1). 3) The incidence of hypothyroidism after RAI treatment in patients younger than 30 years of age was 4.3%(1 year) and 7.7%(2 year); in patients from 30 years to 49 years of age, 5.8%(1 year) and 11.1%(2 year); and in those older than 50 years, 11.0%(1year) and 2 year). The data revealed rising incidence of hypothyroidism with increase of patients' age. 4) Among 116 patients with exophthames the incidence of hypothyroidism by year after RAI treatment was 7.1%(1 year) and 12.15(2 year) while that among 184 patients without exophthalmes was 7.3%(1 year) and 12.2%(2 year) respectively. With the above data the authors could conclude that the hypothyroidism in patients with DTG who were treated by RAI developed more frequently than reported by others in Korea till now, and increased with the passage of time, the yearly increments from 4 years after RAI treatment increasing markedly in the multiple dose group, and the incidence could be reduced by decreasing the administered RAI dose not increasing the duration till euthyroid state after RAI therapy.

한국산 잡견에서의 단일 폐이식술후 조직학적 고찰

이정상 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.3

We have performed 28 single lung transplantation in mongrel dogs transplanting the left lung exclusively from November 1989 to September 1991, in the department of thoracic surgery of Seoul National University Hospital. In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantations and Euro-Collins or modified Euro-Collins solution in the remaining 17 transplantations as a lung preservatives. The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off. In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5-O prolene and the pulmonary artery was anastomosed using 6-O prolene. The bronchus was anastomosed next with 4-O vicryl interruptedly and covered with a greater omentum which had been prepared previously. All dogs received cyclosporin A and azathioprine as immunosuppressants and were divided into two group. In the 10 Group I dogs, they survived within 6 days, mean survival time was 66.8$\pm$53.4 hours. In remainder 14 Group lI dogs, they survived above 6 days, mean survival time was 9. 5$\pm$5.6 days. The cause of death were as follows: 2 cases of sacrifice, 2 cases of respiratory insufficiency during operation, 2 cases of arrhythmia immediate postoperatively, 2 cases of bleeding, others in Group I, and 6 cases of sacrifice, 4 cases of sepsis, 3 cases of bleeding, others in Group lI. Results of bronchoscopic findings were obstruction above 50% in 12 cases of 16 performance cases within 5th day. Early chest radiologic haziness were showed, and total lung perfusion defect was frequently showed in both group within 7th day. Main autopsy findings were left atrial and pulmonary arterial thrombi and bronchial obstruction The major histologic findings of Group I were pleural exudate, hemorrhagic infarct, pulmonary congestion, and interesting histologic findings of Group II were 3 cases of perivascular or peribronchial lymphocyte infiltration, 3 cases of hemorrhage infarct, 2 cases of interstitial pneumonitis. The structual change of bronchioles, suggesting bronchiolitis obliterans was not observed due to improper preparation of proximal pulmonary tissue and short term survival times.

종격동 부신경절종;1례 보고

이정상,김주현,Lee, Jeong-Sang,Kim, Ju-Hyeon 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.1

A case of nonfunctioning paraganglioma of the anterior mediastinum in a 64-year-old woman is presented. The tumor was adherent to the pericardium and parietal pleura but not to the phrenic nerve. Complete excision of the tumor is the treatment of choice, but partial excision may provide long-term survival. A new classification and terminology suggested by Glenner and Grimley is emphasized. This aorticopulmonary paraganglioma is the first case in the Korea.

Application of enzyme sequence similarity network for development of potential antibiotic agents

이정상,윤여준 한국공업화학회 2022 한국공업화학회 연구논문 초록집 Vol.2022 No.-

완전방실중격결손증의 외과적 요법에 관한 임상적 고찰

이정상 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.2

Twenty eight patients had undergone repair of an isolated complete atrioventricular septal defect between April 1986 and September 1990 in Seoul National University Children`s Hospital. The group comprised 13 male and 15 female patients. They ranged in age from 2 months to 8 years[mean 18.6months] and in weight from 3. 4kg to 23kg[mean 9.0$\pm$4.6kg]. They were analysed as Rastelli type A in 17 patients, Rastelli type B in 2 patients, and Rastelli type C in 9 patients. Seven patients had concomitant Down`s syndrome. All patients had large left-to-right shunt[mean pulmonary to systemic flow ratio 3.5 $\pm$2.2 ranging from 0.68 to 10.0] and high pulmonary systolic pressure[mean 74$\pm$18.8mmHg, ranging from 35 to 110]. In 11 patients, one patch technique was used to close the atrial and ventricular septal defect and 16 patients were undergone by two patch technique. We urgently managed only one patient by pulmonary artery banding whose anatomy was Rastelli type C and severe mitral regurgitation was identified. Postoperative complete A - V block was noted in 3 patients, two of whom were dead in operating room due to combined LVOTO and myocardial failure, and one patient with Rastelli type C was undergone by VVI type permanent pacemaker insertion 1wk later after two patch technique, but we had to manage him by modified Konno operation and total correction due to LVOTO and VSD leakage and severe mitral regurgitation 3 years later. Another two reoperation cases due to severe mitral regurgitation after two patch technique were undergone, one of whom we managed by mitral annuloplasty 3 months later but aggravated mitral regurgitation made us to control him by MVR 3 months later. Another one case of VSD leakage and tricuspid regurgitation was managed by total correction but she died of respiratory insufficiency 14 days later. We experienced pulmonary hypertensive crisis in 3 patients, who were dead in two cases comparing with one control case. So operative mortality is 9/27[33.6%], in one patch group of 3/11[29.2%] comparing with two patch group of 6/16[37.5%]. In summary, causes of death were pump weaning failure, myocardial failure and low cardiac output syndrome and pulmonary hypertensive crisis, resp. failure, complete AV block. Mean follow up period is 15.8$\pm$10.7 months[ranging from 3months to 37 months]

養生에서의 호흡법 고찰 - 胎息法과 朱子의 ‘調息箴’ 수용을 중심으로 -

이정상,김종두 한국사상문화학회 2015 韓國思想과 文化 Vol.79 No.-

This study was to occupy an important place in curing breathing, considered the heart of 'Taesikbeop', and it is to learn about the 'Jou-Sic-Jam' summarized by Zhu Xi. 'Jou-Sic-Jam' can be found in the literatures that well-known practice among Joseon Dynasty’s gentry because of the absolute veneration of Zhu Xi. Gentry were treated to cure within the scope of the study, which was also the will to practice the filial piety as the largest effect virtues of Confucianism. Furthermore, breathing was consistent with the basic philosophy of inner discipline in their pursuit of Neo-Confucianism. Gentry can also easy to acquire by keeping the respectability. The fact that ‘Taesikbeop’ was accepted by Confucianism, even though the strong colors of cure, shows the example of gentry’s flexible thinking. The concept of breathing was identified in the flow of energy that the body is working the principle of inspiration ⋅ exhalation working life, which is showing an in-depth thinking to recognize the individual's body as a microcosm. ‘Taesikbeop' will show the principle of uterus where human’s place for the first. Abdomen is home to set the energy and the headquarters of foster Care in God as the source of the power of curing activated. ‘Taesikbeop' now that is recognized as a longing to return to nature as a source of self-existence which were equals the innocent disposition of Confucianism pursued. The health archaeological value of ‘Taesikbeop' has proved its efficiency and has been handed down to today breath abdominal breathing and meditation. This has had a positive effect in the fragile modern, due to money worship, with ‘well-being’ that can grow the inner depths of the heart muscle. 'Taesik’ tonify Jou-Sic-Jam because of that the origin of 'Taesik’ began in China. But, Gentry in Joseon dynasty were settling into its own stance of their own. This can be defined as shows the cultural character of the peninsula. Breathing will also have greater implications that Confucianism, Buddhism and Taoism are fused in terms of totality of oriental studies. 본 연구는 양생(養生) 에서 중요한 위치를 차지하는 호흡법으로, 그 핵심인 ‘태식법’을 고찰하고, 그것을 정리한 주자의 ‘조식잠’에 대해 알아보는 데 있다. ‘조식잠’은 朱子라는 절대자의 숭상으로 인해 조선 사대부들에서 널리 알려져 실천되었음을 그들의 문헌에서 확인할 수 있다. 사대부들은 양생을 학문의 범위 내에서 취급하였고, 이는 유교의 가장 큰 덕목인 효(孝)의 실천을 위한 것이기도 하였다. 더욱이 호흡법은 그들이 추구한 성리학의 기본 이념인 내면 수양(修養)과 부합되었고, 양반이란 체면을 지키면서도 비교적 쉽게 체득할 수 있는 것이었다. ‘태식법’은 도가적 색채가 강한 양생인데도 불구하고 유가들이 적극 수용했다는 사실은 그들의 탄력적인 사고를 보여주는 사례라 하겠다. 호흡의 개념은 생명이 작동하는 들숨⋅날숨의 원리를 인체가 작동하는 기(氣)의 흐름 속에서 파악되었고, 이는 개인의 몸을 소우주로 인식하는 심층적 사고를 보여주는 것이다. ‘태식법’은 인간이 처음 머문 자궁의 원리를 보여주는 것이다. 단전은 원기(元氣)가 집합하는 곳이며, 기가 발동하는 근원으로 양생의 으뜸인 신(神)을 기르는 사령부다. ‘태식법’은 자기 존재의 근원으로 회귀하려는 본성에 대한 갈망으로 인식되었으니 이는 성리학이 추구한 天眞한 심성과 상통되었다. ‘태식법’이 지닌 건강학적 가치는 그 효용성이 입증되어 오늘 날 단전(복식)호흡과 명상으로 전승되어 숨 쉬고 있다. 이는 배금숭배로 인해 내면적 심도가 허약한 현대인들에게 마음의 근육을 키울 수 있는 ‘웰빙’ 이라는 이름으로 긍정적 영향을 미치고 있다. ‘태식’의 유래가 중국에서 시작되어 ‘조식잠’을 유행 시켰지만, 조선 사대부들은 이를 수용하여 나름대로 자신만의 자세로 정착시켜 한국의 의학문화의 한 양상을 이루었다. 이는 반도라는 문화적 성격을 보여주는 것으로 규정할 수 있다. 또한 호흡법은 儒⋅佛⋅禪이 융합된 동양학의 총체라는 점에서 오늘 날 시사하는 바가 크다고 하겠다.

재발성 자연 기흉에 대한 정중액과 개흉술과 비디오 흉강경수술의 비교연구

이정상 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.1

배경: 정중액와 개흉술 및 근래에 많이 시술되는 비디오흉강경수술은 기존 개흉술과 달리 덜 침습적인 수술방법으로 절개 창상이 적으며, 수술 후 동통, 무기폐, 창상감염, 출혈 등이 적고, 입원기간이 단축되며, 미용면에서 유리한 점이 많아 일부 흉부질환에서 선호되는 시술이다. 대상 및 방법: 보라매병원에서는 기존 개흉술중 덜 침습적인 수술요법으로서의 정중액와 개흉술 30례와 비데오흉강경 수술 30례를 연령 18세에서 25세사이의 재발생 자연기흉에 대한 임상례에서 비교연구 하였다. 1992년 1월부터 1993년 12월까지 83명의 기흉수술환자중 18∼25세 사이 30명에 대한 정중액와 개흉술 제 I군과 1994년 1월부터 1995년 8월까지 101례의 비데오 흉강경수술중 56명의 기흉수술에서 18세부터 25세사이 30명 제 II군을 비교검토하였다. 결과: 1) 수술전 흉관거치기간은 제 I군은 2일에서 15일(평균 4.69 2.72일), 제 II군은 2일에서 12일(평균 4.60 2.87일)로서 통계적으로 의미가 없었으며, 2) 수술시간은 피부절개부터 피부봉합까지 제 I군은 40분에서 150분(평균 84.79 21.70분), 제 II군은 58분에서 120분(평균 108.82 42.02분)으로 통계적으로 의미가 있었으며(P<0.0001), 3) 수술후 24시간 흉관배액은 제 I군에서 65 ml부터 400 ml(평균 220.76 106.73 ml), 제 II군에서 70 ml부터 320 ml(평균 260.63 233.18 ml)로서 통계적으로 의미가 없었으며, 4) 수술후 24시간 요구된 Tarasyn 진통제 용량이 제 I군은 0앰플에서 5앰플(평균 1.38 1.32앰플)이며, 제 II군은 0앰플에서 4앰플(평균 0.72 1.02 앰플) 로 통계적으로 의미가 있었으며(P<0.05), 5) 수술후 흉관 거치기간은 제 I군은 3일에서 17일(평균 5.45 3.09일), 제 II군은 2일에서 14일(평균 4.75 3.1일)로서 통계적 의미가 없었다. 6) 수술후 사용한 자동봉합기는 제 I군은 0개에서 3개(평균 1.31 0.06개), 제 II군은 0개에서 11개(평균 3.41 2.37개)로서 통계적 의미가 있었다(P<0.0001). 7) 수술후 합병증은 제 I군에서 12일이상 공기누출이 2례 있었고(6.6%), 제 II군에서는 없었다. 8) 수술후 기흉재발율은 제 I, 제 II군 각각 1례씩 있었다(3.3%). 결론: 이상의 비교검토결과 18세부터 25세 사이의 재발성기흉환자에 있어서 비디오흉강경 수술요법은 정중액와 개흉술에 비하여, 통계적으로 의미있게, 수술시간이 길고, 자동봉합기 사용량이 많고, 수술후 진통제 사용량이 적었으며, 나머지 상기비교지수에서는 통계적으로 차이가 없었다. Background: Although treatment of spontaneous pneumothorax by video-assisted thoracic surgery(VATS) has generally shown better clinical results than conventional thoracotomy, treatment of spontaneous pneumothorax by midaxillary thoracotomy(MAXT) has also shown good clinical results. The author studied to compare the clinical results of MAXT group I and VATS group II. Material and Method : Group I included 30 midaxillary thoracotomy among 83 operative cases of spontaneous pneumothorax from Jan. 1992 to Dec. 1993. Group II included 30 VATS among 101 operative cases of pneumothorax from Jan. 1994 to Aug. 1995. The author selected the 30 patients, age 18 to 25 years, with recurrent spontaneous pneumothorax in each group. The author analyzed the operative indication, gender, operating time, amounts of the used staplers, tube drainage, total amounts of analgesics used during postoperative 24hr, tube stay time, postoperative complications and mortality. Result: The follow-up periods of both procedures were from 6 to 43 months. The operating time from start of skin incision to end of skin closure was 84.79${\pm}$21.70(from 40 to 150) minutes in MAXT group I and 108.8${\pm}$42.02(from 58 to 120) minutes in VATS group II(P<0.001). The numbers of the used staples useo was 1.31${\pm}$0.6(from 0 to 3) in group I and 3.41${\pm}$2.37(from 0 to 11) in group II. The amounts of postoperative 24hour tube drainage were 220.76${\pm}$106.73(from 65 to 400) ml in group I and 260.63${\pm}$233.18(from 70 to 320) in group II(P>0.05). The amounts of postoperative 24 hourly used analgesics(Tarasyn ) was 1.38${\pm}$1.32(from 0 to 5) amples in group I and 0.72${\pm}$1.02(from 0 to 4) amples in group II (P<0.05). The postoperative tube stay is 5.45${\pm}$30.9 (from 3 to 7) days in group I and 4.75${\pm}$3.1(9 from 2 to 14) days in group II(P>0.05). The number of complications after operations was 2 cases of prolonged air leakage in group I, and in group II. (P is not significant). The number of recurrence after the operation was one in group I and also one in group II(P is not significant). In conclusion, there were no statistical differences in the postoperative 24 hour chest tube drainage, days of postoperative tube stay, postoperative complications and recurrence in the analysis between group I and group II. Conclusion: The author found that group II of VATS between 18 years and 25 years of age in recurrent spontaneous pneumothorax, statistically, requires longer operative time, more number of autosuture staples and less postoperative analgesic dosage than the midaxillary thoracotomy group I.