신생아에서 심실중격결손증을 동반한 대동맥궁 결손증의 일단계 완전 교정술 -3례 치험-

전희재 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.6

Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

Random Amplified Polymorphic DNA 분석을 통한 Methicillin 내성 황색포도구균의 분자역학적 조사

전희재,김정만,우종수 대한감염학회 2005 감염과 화학요법 Vol.37 No.1

목적 : 본 연구는 중환자실 환자 및 의료종사자에서 검출된 MRSA의 역학조사에 신속하고 간편한 방법인 random amplified polymorphic DNA (RAPD)의 유용성을 평가하고자 하였다. 재료 및 방법 : 1998년 10월부터 12월 및 2001년 5월부터 7월까지 동아대학교병원 중환자실 입원 환자 및 의료종사자의 검체 각각 10, 15예 및 8, 5예를 대상으로 mecA gene의 유무와 항균제 감수성 검사를 실시하고, 3가지 primer를 이용하여 RAPD를 시행하였다. 결과 : 환자에서 분리된 MRSA 25주 중 21주(84%)와 의료진에서 분리된 13주 중 12주(92%)가 mecA 양성이었고, mecA 양성 MRSA를 RAPD로 분석한 결과 모두 18가지 유형으로 분류되었다. 결론 : RAPD 방법을 이용한 유전자 형별 분석은 MRSA의 균주 분별에 유용하며, 또한 중환자실에서 유행 발생한 MRSA의 신속한 역학조사에 유용할 것으로 생각한다. Background : The random amplified polymorphic DNA (RAPD) analysis was investigated to see if this method could be a useful tool for monitoring of epidemic outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) among patients and healthcare workers (HCW) in the intensive care units (ICU). Methods : Thirty-eight MRSA strains were isolated from patients and HCW in Dong-A University Hospital ICU from October, 1998 to December, 1998 (10 patients and 8 HCW) and May, 2001 to July, 2001 (15 patients and 5 HCW). All strains were typed according to antimicrobial susceptibility and RAPD analysis patterns. mecA genes were detected using polymerase chain reaction (PCR). Results : Twenty one of 25 (84%) and 12 of 13 (92%) MRSA, isolated from patients and HCW, respectively, were mecA positive. mecA positive MRSA were classified into 18 different types by RAPD analysis. Conclusion : DNA fingerprinting using RAPD analysis is a simple, effective, and rapid method for discriminating MRSA strains, and may be applicable in detecting outbreaks of S. aureus infections in the ICU.

빅데이터 분석을 활용한 군사안보지수 개발 연구

전희재,이문걸 한국산업경영시스템학회 2022 한국산업경영시스템학회 학술대회 Vol.2022 No.춘계

Air Turbin Dental Drill에 의해 발생한 종격동 기종및 피하기종;1례 보고

전희재 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.12

Pneumomediastinum and subcutaneous emphysema produced by air turbine dental drills, although widely reported in dental publications, are rarely reported in the thoracic journals. We report a case of 38-year-old man with pneumomediastinum and subcutaneous emphysema after use of a air turbine dental drill for dental extraction.

Endovascular Revascularization for the Obstruction after Patch Angioplasty in Buerger’s Disease

전희재 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.2

Surgical revascularization for patients with Buerger’s disease is possible only in a few cases, due to the diffuse segmental involvement and the lack of distal runoff vessels available for bypass surgery. We encountered a case of resting pain in the right foot, coldness with dysesthesia, and cyanosis on the right 1st toe. The patient was treated with an endovascular intervention after vein patch angioplasty failed due to an inflammatory reaction of Buerger’s disease. We suggest that an endovascular procedure can be an effective treatment, even in addition to more conservative and surgical management, in patients with Buerger’s disease and critical limb ischemia.

Experiences of Surgical Treatment for Juxtarenal Aortic Occlusion

전희재 대한혈관외과학회 2014 Vascular Specialist International Vol.30 No.1

Purpose: To evaluate the outcomes of juxtarenal aortic occlusion (JRAO), a review of 15 patients who underwent aortic bypass replacement following aortorenal thrombectomy, especially focusing on the safety of suprarenal aortic clamping or transient aortic compression, was undertaken. Materials and Methods: During the period of June 2001 to November 2012, 15 patients with JRAO (chronic 10, acute 5) were analyzed retrospectively. JRAO with combined stenosis of the renal artery was found in 2 patients, renal artery thrombus in 8 patients, and normal in 5 patients. Results: All patients were males. Mean age was 61.7±11.2 years. There were 14 aortobifemoral bypass grafting and 1 aortobiiliac bypass grafting. Six Dacron and 9 PTFE artificial Y-grafts were implanted to the aorta with end-to-end anastomosis in the proximal aorta. Suprarenal aortic clamping was performed in 7 patients, supraceliac clamping in 2 patients, and transient aortic compression in 6 patients. There were 13 cases with aortic clamping time <10 minutes and 2 cases with >10 minutes. Thrombectomy of the aorta and renal artery was performed in 10 (66.7%) patients. There were no operative mortality cases. The perioperative morbidity rate was 26.7% (4/15). Preoperative renal function was impaired in four patients. The renal functions of these cases were recovered postoperatively. Conclusion: Aortic bypass replacement following aortorenal thrombectomy with suprarenal aortic clamping or transient aortic compression for JRAO is the optimal treatment. It is important to focus on short renal ischemic time during suprarenal aortic clamping for prevention of renal damage. It provides unmatched perioperative and long-term results.

Takayasu`s arteritis의 수술치험 1례

전희재 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.6

Takaysu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries. The end stage pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch, left common carotid artery and left subclavian artery. The patient was 27 year-old female and she was admitted because of headache and neck pain. Aortogram revealed fusiform dilatation of left common carotid artery with focal narrowing on it`s distal portion. The patient underwent surgical resection and replacement of Dacron tube graft between distal and proximal left common carotid artery. 3 months after operation, she was readmitted because of shoulder pain and headache. Aortogram revealed focal narrowing of proximal left common carotid artery and total obstruction of left subclavian artery which caused subclavian steel syndrome. Aorto-left common carotid and aorto-left subclavian bypass graft replacement were done.

기관에 생긴 선양낭포암 치험 1례

전희재 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.6

Adenoid cystic carcinoma of the tracea is rare, but is a very serious critical life-threatening disease.Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest CT, tomogram and air tracheogram are essential for the further definition of these lesions. This is a case report of adenoid cystic carcinoma in a 47 years old male patient. The tumor was located in cervical trachea with wide base and obstructing the lumen almost completely. The patient`s symptom was productive cough and hoarseness for 4 months. The tumor was resected and End-to-End anastomosed. The tumor was confirmed to be adenoid cystic carcinoma histopathologically. The need for removal of tracheal tumor whether complete or incomplete, is clear enough regardless of the histology of the tumor. This patient was treated post-operatively with radiation.

기관및 기관지 폐색을 야기한 기관지성 낭종 치험 1례

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

The bronchogenic cyst is not so rare in incidence, but it is rare for this cyst to cause compression of trachea and main bronchi. A 6-year old female child was evaluated for coughing, fever and left total atelectasis. This patient had a history of frequent upper respiratory symptom like bronchial asthma since 6month after birth. Fiberoptic bronchoscopy revealed external compression at distal trachea and both main bronchi. Computed Tomography revealed well demarcated homogeneous mass compressing distal trachea and main bronchi. The pathological examination showed bronchogenic cyst and this patient had uneventful recovery.

개심술 후 심폐소생술 실패환아에서의 체외막산소화 치험 1례

전희재,성시찬,우종수,이혜경 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.1

저자들은 심장수술 후 발생한 심정지로 심폐소생술을 시행한 신생아에서 성공적인 체외막산소화 장치(ECMO)사용 1례를 경험하였다. 환자는 울혈성 심부전과 폐동맥 고혈압을 가졌던 4.4kg의 35일된 남아로 술중에 특별한 문제없이 심실중격결손증을 첨포봉합법으로 봉합하였다. 심장 중환자실에서의 술후 경과는 junctional ectopic tachycardia (JET)가 나타나기 전까지 약 5시간 동안은 특별한 문제가 없었다. junctional ectopic tachycardia (JET)가 나타난 후 50분경과한 뒤 갑작스러운 서맥이 나타나면서 수축기 혈압이 50mmHg로 하강하여 곧 흉골절개 봉합부(sternotomy incision)를 열고 심폐소생술을 바로 시행하였으며 심폐소생술을 시행한 지 4시간 후에 상행대동맥에 동맥관을 그리고 정맥관은 우심방이에 삽관하여 체외막산소화 장치를 시작하였다. 환자의 혈액동력학은 체외막산소화 동안 안정적이었으며, 시작 후 38.5시간 만에 중지하였다. 흉골지연봉합을 시도하였고, 환자는 수술 후 7일째 인공호흡기를 제거했으며, 신경학적 합병증없이 수술 후 21일째 퇴원하였다. We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.