심막강 내 탈장과 심압전이 동반된 중앙부위 횡격막 파열

백광제,선경 대한외상학회 1997 大韓外傷學會誌 Vol.10 No.1

Traumatic diaphragmatic hernia into the pericardial sac is a rare and often fatal condition. We report a case of diaphragmatic rupture due to blunt trauma with intrapericardial herniation of transverse colon and omentum. A 54 year-old male patient presented with the symptoms of bilateral multiple rib fractures and the signs of cardiac tamponade and shock. After stabilization, peristaltic bowel sound was audible on the anterior chest, however, repeated chest sonography failed to demonstrate hollow viscus shadow. Intrapericardial herniation of the colon was diagnosed by the delayed film in small boweI series. The patient underwent left thoracotomy through the 7th intercostal space, and the ruptured diaphragm and the pericardium were repaired after reduction of herniated viscus. The patient has been in a normal active life during 7 year follow-up postoperatively.

Mucoepidermoid Carcinoma 치험 1예

백광제 대한흉부심장혈관외과학회 1986 Journal of Chest Surgery (J Chest Surg) Vol.19 No.3

Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

심실중격결손증의 임상적 고찰

백광제 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.2

From 1977 through 1984, 97 patients of V.S.D. were treated surgically at Department of Thoracic and Cardiovascular Surgery, Korea University college of Medicine. Among 97 patients, 3 patients were treated by PDA ligation, 3 patients were treated by PDA ligation and subclavian flap aortoplasty, 1 patient were treated by pulmonary artery banding. All of the above patients were analyzed clinically. The results were as follows; 1. Of the patients, 52 patients were male [55.5%] and 45 patients were female [44.5%]. Their age ranged from 7 days to 32 year, and the mean age was 9 year of age and 28.9% of patients were between 4 and 8 year of age. 2. The most common clinical symptoms were frequent U.R.l. and D.O.E.. 3. The most common chest PA findings were cardiomegaly and increased pulmonary vascularity. 4. Associated anomaly was founded in 27 cases and PDA was most common associated anomaly and others were A.S.D., pulmonary stenosis, aortic regurgitation, D.C.R.V.. 5. Pulmonary hypertension was founded in 37 patients and it`s incidence was increased by patient age and shunt amount. 6. On Kirklin`s anatomical classification, type 11 defect was most common [45.5%], and type 1 was 35.5%, and type 111 was 4.4%, and type 1V was 4.4%. 7. Mean E.C.C. time was 69.1 min. and varied by closing method and associated anomaly as in case of simple closure; 47.8 min., in case of patch closure; 77.2 min., in cases with associated anomaly; 92.7 min.. 8. Mean postoperative ventilatory assisted time was 7.3 hour and varied by preoperative pulmonary artery pressure and E.C.C. time, as the group with pulmonary hypertension; 10.5 hour, the group without pulmonary hypertension; 5.5 hour, the group of short E.C.C time [within 1 hour]; 4.4 hour, the group of long E.C.C. time [over 1 hour]; 8.4 hour. 9. Overall operative mortality was 9.3% [9 cases].

진행성 식도암의 Celestin`s tube 를 이용한 고식적 치료

백광제 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.3

Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

췌장조직을 함유한 종격동 기형종 (1예 보고)

백광제,선경,김학제,김형묵,김인선 大韓胸部外科學會 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.1

외상성 횡격막 손상

백광제 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.10

13 cases of traumatic diaphragmatic ruptures were treated at the department of thoracic and cardiovascular surgery in Lee-Rha general hospital, Cheong-Ju, Choong Cheong Buk Do, between Oct. 1989 and Feb. 1992. The above 13 cases were reviewed in this study. And the following results were obtained. 1. Sex ratio is 11: 2 with male dominance 2. The 9 cases were due to blunt trauma and other 4 cases were due to penetrating injury. 3. Right side injury was more common than left[7: 5] and there was 1 case of central type which ruptured through subepicardial diaphragm. 4. All of the cases had association injury. 5. Preoperative diagnosis was possible in the 9 cases and others were diagnosed during operation under other indication. 6. Finger exploration was one of effective diagnostic procedure. 7. All of diaphragmatic ruptures was corrected through thoracotomy and exploratory laparotomy was done in 6 cases. 8. A patient died after operation due to associated injuries.

실험쥐의 고농도 산소 폐손상에서 N - acetylcysteine 투여후 형태학적 변화

백광제,김준식 대한외상학회 1998 大韓外傷學會誌 Vol.11 No.1

Although oxygen therapy has been of clear benefits in many clinical settings, it also carries risk of oxygen toxicity to the lung tissue. But the physicians involved in emergency and intensive care are frequently confronted by situations in which prolonged hyperbaric therapy is a necessary management of the patient care. The biochemical basis of oxygen toxicity is increased production of highly reactive, partially reduced metabolites of oxygen, included hydrogen peroxide and free radicals, by cells in hyperoxia. We studied the effects of intravenous N-acetylcysteine(NAC). A free radical scavenger, upon the mouse which is exposured to hyperoxic condition for 96 hours. We found that the PMN inflammatory cells are much less infiltrated in NAC group and also less alveolar congestion, septum edema, and peribrochial edema. Thus, NAC significantly attenuated all morphologic pathologic changes in the hyperoxic model of mouse, possibly its ability to scavenge toxic oxygen free radicals.

폐분리증 : 증례보고 A Case Report

백광제 건국대학교 1996 學術誌 Vol.40 No.2

Pulmonary sequestration is a masses of distorted, nonfunctioning, pulmonary tissue that have no normal connections with the bronchial tree and receive their blood from anomalous systemic arteries and it is the largest group of bronchopulmonary foregut malformation. Pulmonary sequestration is classified as ILS(intralobar pulmonary sequestration) and ELS(extralobar pulmonary sequestration). ILS is a disorder which is seperated from the normal lung tissue incompletely and ELS is a disorder which is separate from normal lung tissue completely and have its own pelural cover-age. In old patients the pulmonary sequestration is manifested by nonspecific symptoms and signs, such as dry cough, recurrent pulmonary infection, chest pain, hemoptysis. Diagnostic procedures are plain radiologic study, computerized tomography, angiography. But definite preoperative diagnosis is very difficult because there are no specific signs. The treatment of pulmonary sequestration is complete surgical resection with meticulous dissectin and division of aberrant artery. We experience a case of intratobar pulmonary sequestration which is treated by left lewer lobectomy.

급성 폐손상시 기관지 확장제의 분무치료가 폐유순도에 미치는 영향에 대한 실험연구

백광제 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.6 No.-

The acute respiratory distress syndrome(ARDS) is a disorder of diffuse lung injury secondary to a wide vareity of clinical insults(e. g sepsis) and is manifested by impaired oxygenation, pulmonary edema, and decreased static ad dynamic compliance. Reduced lung compliance is a hallmark of the syndrome and has generally been considered the primary lung mechanics abnormality. We designed this study to confirm the presence of decreased lung compliance in animal model with acute lung injury and to determine whether these changes are reversible using an aerosol beta-agonist such as salbutamol and nicorandil. We studied 6 dogs with oleic acid induced acute diffuse lung injury. We measured hemodynamic data, dynamic compliance, arterial blood gas analytic data during the experiment. Lung compliance and other lung mechanics and hemodynamic data are impaired with acute lung injury of experimental dogs. Aerosolized beta agonist significantly increased the lung compliance and tend to improved the gas exchange mechanics.

익수환자의 임상고찰

백광제 대한외상학회 1997 大韓外傷學會誌 Vol.10 No.2

Drowning is a death from suffocation after submersion and near drowning is survivor after drowning at least temporarily. It is one of major cause of seasonal accidental death especially in summer. I did analysis 12 near drowning patients(including drowning) for future planning of treatment and study. The results is as follows: 1. Ten patients were males and two females and the age range was 3 to 60 years with a mean of 28.6 years. 2. All of our cases were salt water drowning 3. Three patients who have mild symptoms and normal chest radiologic finding were discharged after short term observation in emergency center. 4. Five patients who have symptoms and pulmonary edema were admitted and 4 patients required ventilator care and one received supportive therapy. 5. Three complications(1 multiple organ failure, 2 pneumonia) were developed from the patients who received ventilator care. 6. Cardiopulmonary resuscitation was done for five patients and heart beats were recovered in two patients. 7. Seven patients were survive after drowning.