외상에 의한 상행 대동맥 박리증의 치험 1례

서필원,채헌,Seo, Pil-Won,Chae, Hurn 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

Aortic dissection is a challenging disease and the causes of that are well-known. Blunt chest trauma is one of the causes of aortic dissection. In such cases, nearly all cases involves the isthmic portion of descending aorta, but ascending aorta is involved in about 10. We experienced a patient who had ascending aortic dissection due to automobile accident and who showed spontaneous rupture of the aorta during operation. In this case, after installation of aortic line via left femoral artery, ascending aorta ruptured and a large amount of blood gushed out, which was suckered by cardiotomy sucker. A little delay of cardiopulmonary bypass may cause the fatal outcome in such a case because the bleeding from aorta is too much to be controlled. Fortunately, we controlled the bleeding with cardiopulmonary bypass and got the good outcome of this patient by interpositioning the vascular graft. One should suspect the possibility of aortic dissection in blunt chest trauma, and prepare all the facilities against bleeding due to rupture.

중증 근무력증의 외과적 요법 - 25례 보고 -

서필원,성숙환,김주현,Seo, Pil-Won,Seong, Suk-Hwan,Kim, Ju-Hyeon 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

Myasthenia gravis is a disorder of neuromuscular transmission characterized by weakness and fatigue of voluntary muscles. It is now reasonably established to be due to an autoimmune attack directed against the postsynaptic nicotinic acetylcholine receptors of voluntary muscles. Thymectomy has become increasingly important in the treatment of this disease after the successful case of Blalock in 1939. From January 1984 to December 1988, we performed total thymectomy in 25 cases of myasthenia gravis except one, and get the results as follows. l. Among 25 cases, male to female was 10:15 and the age was ranged from 16 years to 65 years. 2. Thymectomy was done in 24 cases and 1 case of malignant thymoma was not resectable. 3. There were 2 deaths after thymectomy due to myasthenic crisis. 4. There were 19 cases [76 %] of improvement after thymectomy as follows; complete remission was 6 cases [24 %], marked improvement was 9 cases [36 %] and subjective improvement was 4 cases [16 %]. 5. The effect of age, and duration of disease on operative result was not statistically significant, but that of thymic pathology was significant.

심폐바이패스없이 제한적 전흉부개흉술로 시행한 관상동맥우회술 1례

서필원,김삼현,이상민,김영권,박이태 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery Vol.29 No.11

We have experienced a case of coronary artery bypass surgery without extracorporeal circulation through limited anterior thoracotomy. The lesion was a single vessel disease involving the take off of the left anterior descending artery(LAD) which showed tubular lesion with irregular contour and eccentric stenosis of more than 95% luminal narrowing. Percutaneous transluminal coronary angioplasty(PTCA) seemed to have moderate success rate and moderate complication rate. A segment of left internal mammary artery(LIMA) from the second rib down to the sixth rib was harvested through the bed of resected fourth costal cartilage. Anastomosis between LIMA and LAD was performed under beating condition. The patient was extubated in the operation room and showed excellent postoperative course without complications. The coronary angiography on the postoperative 7th day revealed good patency at the anastomosis site.

대동맥과 우심실사이의 누루를 동반한 대동맥판막 및 삼첨판막의 감염성 심내막염 치험 1례

서필원,안혁,Seo, Pil-Won,Ahn, Hyuk 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.5

We experienced a case of infective endocarditis of aortic valve and tricuspid valve associated with a fistula between aorta and right ventricle. The patient was 35 years old woman and showed severe congestive heart failure. Large and multiple vagetations were found on the valvular surfaces and a fistula was present between aorta and right ventricle. Probably infective endocarditis of aortic valve resulted in annular abscess and as it healed, a fistula was formed and tricuspid valve endocarditis followed. We replaced the aortic valve and tricuspid valve with St. Jude mechanical prostheses, and closed the fistula opening with suture. The postoperative course was smooth and the patient has no problems till now 4 months after operation.

A Study on the Characteristics of CO Oxidation at Room Temperature by Pt/TiO₂ Catalyst

서필원,김성수,강연석,홍성창 한국공업화학회 2010 한국공업화학회 연구논문 초록집 Vol.2010 No.-

A Study of the Increase in SCR Activity of the V/TiO₂ Catalyst through the pH Control

서필원,박광희,이상문,최현진,권동욱,홍성창 한국공업화학회 2010 한국공업화학회 연구논문 초록집 Vol.2010 No.-

물을 활용한 DAO 분해 반응에서 촉매에 따른 영향 연구

서필원,박선영,( Duy Van Pham ),( Ali Hassan Bhatti ),강기혁,윤다님 한국공업화학회 2024 한국공업화학회 연구논문 초록집 Vol.2024 No.1

Snuffbox에 시행한 혈액투석을 위한 동정맥루조성술

서필원,류재욱,박정옥,장성욱,김미순,박성식,김삼현 대한흉부외과학회 2004 Journal of Chest Surgery Vol.37 No.2

배경: 원발성 자연 기흉의 치료에 있어서 단순히 기포절제술 또는 기낭절제술만 시행한 경우에 비해 흉막 유착술을 같이 시행한 경우, 수술 후 재발률을 줄일 수 있는 방법으로 인식되고 있다. 흉막 유착술의 방법에 있어 탈크 가루를 이용한 화학적 흉막 유착술과 폐첨부 흉막 박리술을 이용한 기계적 흉막 유착술의 장단점 및 재발률 등의 임상 결과를 비교하였다. 대상 및 방법: 2001년 1월에서 2002년 6월까지 원발성 자연 기흉으로 흉강경 수술을 받았던 환자 152명(흉막 박리술-68명, 탈크 유착술-84명)을 대상으로 하였으며, 평균 연령은 폐첨부 흉막 박리술 시행 군이 23.5 12.1세(14∼46세), 탈크 유착술 시행군이 26.2 9.0세(16∼44세)였다. 결과: 추적 관찰 기간과 재발률은 박리 군에서 68명 중 5∼17개월(12.56 2.98개월) 동안 1명(1.47%)이었고, 탈크 군은 84명 중 평균 5∼15개월(10.75 3.09개월) 동안 1명(1.19%)으로 나타나 통계적 유의성은 없었다(p=1.000). 이차 시술의 소요 시간은 박리 군의 경우 평균 14.4 2.5분이었고, 탈크 군은 평균 4.4 1.5분으로 탈크 군보다 박리 군이 유의하게 길었다(p<0.001). 수술 후 통증의 변화는 박리 군에는 0이 48명(70.6%), 1이 12명(17.6%), 2가 4명(5.9%), 3이 4명(5.9%)이고, 탈크 군에서는 각각 16명(19.0%), 18명(21.4%), 24명(28.6%), 26명(31.0%)으로 나타났으며, 통계검증 결과 수술 후 흉부 통증은 박리 군보다 탈크 군에서 유의하게 증가한 것으로 나타났다(p<0.001). 술 후 합병증으로는 박리 군의 경우 5일 이상의 공기 누출이 1명, 탈크 군에서는 공기 누출이 1명, 농흉이 1명 있었다. 결론: 탈크 유착술은 흉막 박리술과 달리 시술 시간이 거의 걸리지 않고 비교적 간단히 할 수 있으나, 흉강내 외부물질이 투여되는 것이어서 농흉과 같은 합병증이 생길 가능성이 있다. 흉막 박리술과 탈크 유착술에 따른 재발률은 유의한 차이가 없는 것으로 판단된다. 탈크 유착술은 흉막 박리술에 비해 술 후 통증이 심한 편이다. 이상으로 재발률에서 유의한 차이를 보이지 않는 이상 각각의 장단점이 있으므로 어느 것이 우수하다 단정 지을 수는 없으며, 두 술식의 장단점을 고려하여 환자 개개인에게 적절히 사용될 수 있으리라 판단된다.

Surgical Treatment of Ruptured Renal Artery Aneurysm: A Report of 2 Cases

서필원 대한흉부외과학회 2013 Journal of Chest Surgery Vol.46 No.6

The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.

좌관상동맥 입구협착의 외과적 확장술

서필원 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery Vol.28 No.3

The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.