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결핵성 기관 및 주기관지 협착에 대한 재건술 −1예 보고−
도형동,이정철,백종현,이장훈 대한흉부외과학회 2009 Journal of Chest Surgery (J Chest Surg) Vol.42 No.5
A 20 year old woman had developed stenosis at the lower part of the trachea, right main bronchus, and right upper lobe bronchus as a complication of endobronchial tuberculosis. The patient had complained of severe dyspnea. Tracheobronchial stenosis was so extensive that we did reconstruction of the trachea and right bronchus with resection of the lower trachea and right main bronchus and right upper lobectomy. She has been doing well without any respiratory symptoms or complications. 기관지내 결핵을 앓아오던 20세 여자 환자가 기관하부와 우측 주기관지, 우측 상엽 기관지 협착이 발생하였다. 이로 인하여 환자는 심한 호흡곤란을 호소하였다. 협착이 광범위하여 하부 기관, 우측 주기관지 및 우상엽 절제술 후 기관 및 주기관지 재건술을 시행하였다. 4년이 지난 현재까지 별다른 합병증 없이 추적 관찰 중이다.
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외해부학적(Extraanatomical) 우회로조성술을 시행한 성인 대동맥축착증 -3예 보고-
이동협,정태은,이장훈,이정철,도형동,한승세 대한흉부외과학회 2008 Journal of Chest Surgery (J Chest Surg) Vol.41 No.2
We performed three cases of extraanatomic bypass graft for treating adult coarctation. Two cases of left subclavian artery to descending aorta bypass graft were done via left thoracotomy for treating 2 patients who had extensive aortic occlusive disease. One case of ascending aorta to descending aorta bypass graft and aortic valve replacement was done via median sternotomy for a patient who had combined arch hypoplasia and aortic valve regurgitation. One patient was reoperated on for aneurysm rupture of an anastomosis site four months after the first operation and two patients have had no specific problems during and after their operations.
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관상동맥 우회술 환자의 술 후 합병증 예견에 대한 BNP의 역할
정태은,이동협,이장훈,도형동,한승세 대한흉부외과학회 2008 Journal of Chest Surgery (J Chest Surg) Vol.41 No.1
Background: Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure. The aim of our study was to investigate whether preoperative and postoperative BNP levels could predict postoperative complications and outcomes in patients after coronary artery bypass graft (CABG). Material and Method: Data was collected prospectively on 30 patients (M/F=19/11, age 60.0±9.6 years) undergoing conventional CABG during a 1-year period beginning on January 1, 2005. Patients underwent off-pump CABG, and combined surgery was excluded. The BNP assay was performed preoperatively, immediate postoperatively at the intensive care unit (ICU), and 1, 3, 5, and 7days postoperatively. Result: Preoperative BNP levels significantly correlated with preoperative echocardiographic ejection fraction and an ICU stay of 5 days or more (r= 0.4, p=0.028; r=0.39, p=0.031, respectively). A preoperative BNP cut-off value above 263 pg/mL demonstrated high specificity (90.5%) for predicting postoperative complications using the receiver operating characteristics curves. Preoperative and postoperative (7 days) BNP levels were different depending on the abscence (mean BNP=99±23 pg/mL vs. 296±74 pg/mL, p<0.05) and presence (mean BNP=212±29 pg/mL vs. 408±23 pg/mL, p<0.01). Conclusion: Preoperative BNP levels >263 pg/mL predict postoperative complications in patients receivingCABG.
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