심장판막 질환 성형술에 대한 임상적 고찰

김윤,조범구,홍승록,Kim, Y.,Cho, B.K.,Hong, S.N. 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

Operations for cardiac valvular disease has been progressed in various ways. Since 1949 when Lord Russel operated mitral stenosis by closed technique at Johns Hopkins Hospital then much progress has been achieved and that nowadays severely diseased cardiac valve has been replaced by prosthetic valve, which is almost ideal in hemodynamic aspect, but still it has many problems such as thromboembolism, destruction of red blood cell, pressure gradient, and disturbance of left ventricular function, so in case of delicate situations, valve replacement should be decided carefully. Besides prosthetic valve, there are some kinds of reconstructive procedures and these have been resulted in better prognosis than prosthetic valve replacement in selected cases. So, authors have reviewed 61 Cases of cardiac patients who have been operated reconstructive valvular surgery by cardiopulmonary bypass, at Yonsei University, from Jan. 1963 to Mar. 1976. Out of 61 cases, 9 patients were replaced by prosthetic valve and rest of the patients were operated upon in various reconstructive procedures such as commissurotomy, valvotomy, valvuloplasty, and annuloplasty. Twenty cases of congenital heart diseases with valvular lesion, which had been operated for valvular lesion were also included in this statistics. Out of 9 cases of prosthetic valvular replacement five cases of prosthetic valvular replacement was done combined with other reconstructive procedures after attempted valvuloplasty. Comparative prognosis of both procedures are somewhat variable by reporters, average 19% of mortality after reconstructive surgery and 38% of mortality after prosthetic valve replacement in long term results. Most common cause of death in postoperative period was low output syndrome in both cases. It seems that good preoperative evaluation and proper reconstructive surgery will afford good prognosis in selected cardiac valvular diseased patient.

우심증에서 부분 폐정맥 이상환류를 동반한 심방중격결손 -1례 보고-

장명,장병철,조범구,홍승록,Chang, M.,Chang, B.C.,Cho, B.K.,Hong, S.N. 대한흉부심장혈관외과학회 1979 Journal of Chest Surgery (J Chest Surg) Vol.12 No.1

Partial anomalous pulmonary drainage is frequently accompanied by an atrial septal defect. The anomaly is entirely compatible with life and the clinical findings are dependent primarily on the proportion of the pulmonary venous return to the right atrium. The anomaly is frequently missed even with complete diagnostic study. In this report we are presenting a case of anomalous pulmonary venous drainage combined with atrial septal defect and dextrocardia and the treatment of this condition.

폐(肺)에 발생한 Hamartoma 치험 2예

이두연,윤여준,조범구,홍승록,이옥순,최인준,Lee, D.Y.,Yoon, Y.J.,Cho, B.K.,Hong, S.N.,Rkee, O.S.,Choi, I.J. 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.1

Pulmonary hamartoma is often incidental, asymptomatic finding on routine chest roentgenogram. It has been considered a congenital malformation. Since the original description by Albrecht in 1908, it has been classified into two types, a small, fibrocartilaginous mass in adults, and a cystic lobar mass in infants. We experienced two cases of pulmonary hamartoma which proved to be the adult form of hamartoma. One was located in left upper lobe of a 58 year old male patient, the other was located in the perihilar region of the right middle lobe of a 38 year old male patient. The former case was treated by wedge resection: the latter by right middle lobectomy and the postoperative courses of both cases were very good and without complication.

폐 Aspergillosis - 9예 보고 -

조규석,이두연,조범구,홍승록,Cho, K.S.,Lee, D.Y.,Cho, B.K.,Hong, S.N. 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.1

Pulmonary aspergillosis is a rare disease, mostly commonly presenting as secondary invasion of pre-existing cavitary disease. In severance hospital, 9 patients have recognized as having this disorders in the 16 years from 1960 to April, 1976. The diagnosis of the aspergillosis has been made by examination of tissues removed at surgery in severance hospital, all the cases of aspergillosis except one (a Lt upper lobectomy due to bronchiectasis, performed 20 years ago) the case had been diagnosed as pulmonary tuberculosis and treated with anti-tuberculosis drugs for periods ranging from 2 to 14 years the most common presenting symptoms were hemoptysis, blood-tinged sputum and cough for a long time. All of the cases were confirmed by pathological examination to be aspergillosis superimposed on underlying tuberculosis and/or bronchiectasis three cases were suspected clinically by fungus cultures, seven cases were confirmed as aspergillosis, after surgery. One patient died following surgery because of bleeding and pulmonary insufficiency.

신경섬유종 (Neurofibroma) 환자에서 발생한 악성 Schwannoma -3예 보고-

김훈,이두연,조범구,흥승록,김성규,조남훈,Kim, H.,Lee, D.Y.,Cho, B.K.,Hong, S.N.,Kim, S.K.,Cho, N.H. 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.6

We experienced 1 year old female patient with partial anomalous pulmonary venous return of the right lung into the inferior vena cava with atrial septal defect. Total anomalous venous drainage from the right lung is an uncommon form of congenital defect, and it may or may not be associated with an atrial septal defect. One patient having this venous anomaly is presented with a detailed description of the surgical reconstruction used. The postoperative result has been satisfactory.

경정맥(經靜脈) 내적(內的) Pacemaker 이식후(移植後) 발생(發生)한 복잡한 감염합병증(感染合?症)의 1치험례(治驗例)

이두연,윤여준,조범구,홍승록,Lee, D.Y.,Yoon, Y.J.,Cho, B.K.,Hong, S.N. 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

Implantation of a permanent pacemaker is a widely accepted procedure for the patient with complete heart block.As a result of these device, the prognosis for patients with Adams-Stokes syndrome caused by complete A-V block and other cardiac arrhythmia have become much more optimistic. Permanent pacemaker implantation by means of a transvenous approach has made the operative risk much less and the procedure simpler. However, a number of complications have been reported in the literature regarding transvenous endocardial pacemaker implantation during the last a decade. The patient presented in this paper is a 26-year old girl who was implanted with a permanent pacemaker at 14 years of age because of a congenital A-V block. Following first exchange of pulse generator, the electrode (lead) was fractured, so that by the pulse generator, a change to the transvenous technique of implantation was made, After this, there were episodes of recurrent wound infection on three occasions, even though the site of pulse generator implantation was exchanged to the contralateral side of chest wall, massive doses of antibiotics were administered and sensitivity tests for coagulase positive staphylococcal infection were performed. Though there was no definite evidence of blood stream infection by blood culture, we decided not to use the transvenous technique and not to implant the pulse generator in the chest wall because the venous system and the entire anterior chest wall appeared to be diseased or contaminated by virulent pyogenic organisms. Finally this intractable systemic and local wound infection was successfully controlled by myocardial lead implantation via a subxiphoid approach and implantation of the pulse generator far down in the abdominal wall. The causes and routes of recurrent wound infection and possible blood born infection in this particular patient are still obscure. We strongly believe that myocardial pacemaker implantation is much safer than transvenous endocardial pacemaker implantation & myocardial pacemaker implantation is a definite method for controlling such an intractable wound infection. following transvenous pacemaker implantation.

대동맥교약증의 임상연구

김훈,강면식,홍유선,조범구,홍승록,Kim, H.,Kang, M.S.,Hong, Y.S.,Cho, B.K.,Hong, S.N. 대한흉부심장혈관외과학회 1989 Journal of Chest Surgery (J Chest Surg) Vol.22 No.1

Coarctation of aorta, a well known congenital cardiovascular defect, can be recognized in the most instances by simple finding of physical examination. This condition shortens life if untreated, but it can be corrected surgically to render the patient functionally normal. It seems relatively rare in Asian. During Six-Year period from January, 1982 through June, 1988, twenty four consecutive operations for the coarctation of the aorta were performed at Yonsei Medical Center. The patients included 14 males and 10 females in the range, 2 months and 34 years old. Associated Cardiac anomalies were patient ductus arteriosus, ventricular septal defect, mitral valve regurgitation, aortic stenosis, double outlet right ventricle, corrected transposition of great vessel, etc. The preoperative main symptoms were frequent URI and dyspnea. Congestive heart failure was the most common symptom at the group younger than 2 year olds. Operative techniques for the coarctation of the aorta were prosthetic patch aortoplasty in 18 patients, resection & vascular graft interposition in 4, resection and end to-end anastomosis in 2. There was no operative death. Four patients had persistent or paradoxical hypertension, and one had postoperative paraplegia.

외상성 하행흉부대동맥 내막 파열 -치험 1예 보고-

장명,장정수,강면식,조범구,홍필훈,Chang, M.,Jang, J.S.,Kang, M.S.,Cho, B.K.,Hong, P.W. 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.3

The rupture of the aorta commonly follows major blunt trauma to the thorax. It has markedly increased in recent years, paralleling the rising number of vehicular accidents. The most frequent site of rupture is the area of the isthmus, with the ascending aorta second. The diagnosis of the condition from clinical data is difficult, and aortography is used whenever aortic tear is suspected. We are presenting a case of patient who had intimal tearing of the thoracic aorta with multiple injuries. The patient underwent surgical repair 28 days after injury with left heart [LA-Femoral artery] bypass.

先天性 巨大結腸에 對한 手術

李世淳(S. S. Lee),金光洙(G. S. Kim),趙範九(B. K. Cho),崔廈景(H. K. Choi),徐相賢(S. H. Suh),洪弼勳(P. W. Hong) 대한외과학회 1968 Annals of Surgical Treatment and Research Vol.10 No.6

말초 폐색성 동맥질환에서 Prosraglandin E1의 동맥내 투여와 정맥내 투여에 따른 효과의 비교

조범구,최수승,강면식,김해균,유경종 대한혈관외과학회 1989 Vascular Specialist International Vol.5 No.1

Twelve patients with peripheral occlusive vascular disease who were not candidates for a surgical correction or had recurrence of symptoms following previous surgical procedures were given Prostaglandin El (PGE1) to assess its effect on their subjective Group I (6 patients) received PGE1 intraarterially (0.1 0.26ng/kg/min) and group II, the same intravenously (7. 8 10 ng/kg/min), The study periods lasted 2 to 4 weeks. 1. In both groups, the skin temperature rose not only on the affected limb but also on the contralateral limb, indicating an improved skin circulation in both extremities. 2. Subjective symptom improvement were as follows ' cold sensation and numbness 100.0 % in both groups ' intermittent claudication 67.0% in group I and 33.0 % in group II; resting pain 100.0% in group I and 75.0% in group II, suggesting a slightly more favorable response in group I . 3. Objectively, the improvement in the ulcerative and necrotic changes were noted in 57.09% in group I and 71.0% in group II, showing slightly better response in group II. 4. Minor side effects such as knee joint swelling and redness at the site of catheter insertion were seen in 4 of 6 patients in group I and only 1 in group II. In summary, the intraarterial infusion of PGE1 proved to be more effective in producing improvement of subjective symptoms but associated with higher incidence of minor complications. On the other hand, the intravenous use of PGE1 appeared to be slightly more effective in the management of the ulcerative and necrotic processes. It is recommended, therefore, that a period of intravenous administration of PGE1 be tried before proceeding to the intraarterial use, if there are signs of improvement with the former method.