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      • SCOPUSKCI등재

        흉곽내 낭종에 관한 임상적 고찰

        정성운,김종원,Jeong, Seong-Un,Kim, Jong-Won 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.7

        Intrathoracic cyst was considered rare entity but one of the important diseases in the field of thoracic surgery. Authors had experienced 17 cases of intrathoracic cysts that were treated in the department of thoracic and cardiovascular surgery of Pusan NationalUniversity Hospital for 10years from January, 1983. to December,1992. The summary is as follows: Their age distribution was from 2 years and 9 months to 59 years of age, mean age 27.2 years. There were 8 males and 9 females. The type of intrathoracic cyst was 10 cases of Bronchogenic cyst, 2 cases of Pericardial cyst and 4 cases of Non specific cyst. The anatomical locations of intrathoracic cysts were 6 cases of anterior mediastinum, 2 cases of middle mediastinum, 3 cases of posterior mediastinum and 6 cases of lung parenchyme. The most common symptom was coughing and followed by general weakness, fatigue, chest pain & discomfort and hemoptysis and 6 patients were asyptomatic. The successful complete removal was done at all cases.Postoperative complications were developed in 5 patients but there was no case of hospital mortality.

      • SCOPUSKCI등재

        기관지확장증의 임상적 고찰

        정성운,정황규,Jeong, Seong-Un,Jeong, Hwang-Gyu 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.11

        We managed 80 patients of bronchiectasis from Jan.1983 to Dec.1992 admitted to the department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital. We evaluated clinically these patients and summarized as follows. Alpha-hemolytic streptococcus was the most commonly found bacterial strain in microbial study. For the conservative treatment, first generation cefalosporins, aminoglycosides and ampicillin were used as antibiotic therapy in this order of frequency. The preoperative final diagnosis was made by bronchography and HRCT. In the image study saccular type bronchiectasis was 47.1%, cylindrical 27.5%, mixed 17.6% and varicose 7.8%. Anatomically left side involvement was more frequent than the right as 61.2% to 38.8% and the most commonly invading lobar area was left lower. Reversibility after conservative treatment for all the types of bronchiectasis was 66%. Surgical treatment were done in 50 cases, among these left lower lobectomy was 38.0%, left lower lobectomy with ligular segmentectomy 22.0%, right middle and lower bilobectomy 16.0%, right lower lobectomy 10.0%, left pneumonectomy 10.0%, right pneumonectomy 4.0%. In 10 cases, there remained some lesion in the other sites of lung parenchyme after first attempt surgical resection because the distribution of lesion is too broad to resect out in single thoracotomy hoping improvement by medical management.

      • SCOPUSKCI등재

        복부 손상을 동반한 흉부손상 환자의 외과적 치료

        정성운,김병준,이성광,Jeong, Seong-Un,Kim, Byeong-Jun,Lee, Seong-Gwang 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.9

        Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.

      • SCOPUSKCI등재

        대동맥 장골동맥 폐쇄성 질환에서 혈관 우회술의 임상적 고찰

        정성운,이형렬,김종원,Jeong, Seong-Un,Lee, Hyeong-Ryeol,Kim, Jong-Won 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.10

        Between Jan.1990 and Mar.1994, twenty-three patients[Male:20, Female:3 with aortoilac occlusive disease had underwent reconstruction [bypass garft . Two main causes of occlusion were atherosclerosis [21 patients and chronic thromboembolism[2 patients . Indications for operation were disabling claudication in 20 patients and critical limb ischemia in 12 patients. The procedures of operation included femorofemoral[8 , axillobifemoral[6 , aorto-bifemoral[6 , axillounifemoral[2 , aortoiliac[1 bypass graft. Postoperatively one patient died for sepsis and the operative mortality was 4.3%. Various anticoagulant therapy were maintained for at least six months. The 1year, 2year, 3year and 4year patency rates of bypass graft after operation were 91.3%, 80.8%, 71.4% and 58.4% respectively.

      • KCI등재

        근치적 자궁절제술을 시행받은 자궁경부암 환자의 임상적 고찰

        정성운(Seong Un Jeong),조성중(Sung Joong Cho),김장환(Jang Hwan Kim),이남우(Nam Woo Lee),김경진(Kyung Jin Kim),박미혜(Mi Hae Park),황인택(In Tak Hwang),정지학(Ji Hak Jung) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8

        목적: 근치적 자궁절제술을 시행 받은 자궁경부암환자의 임상적 고찰을 통해 수술 후 치료 성적을 분석해 보고자 한다. 연구방법: 1983년 1월부터 1992년 12월까지 을지 대학병원에서 광범위 근치적 자궁절제술을 시행 받은 자궁경부암 환자 중 추적관찰이 가능했던 162예를 대상으로 하였다. 결과: 나이 분포는 40대와 50대, 30대순이었고 환자의 임상 병기 분포는 Ia기가 12예(7.4%), Ib기가 84예(51.9%), IIa기가 39예(24.1%) 그리고 IIb기가 27예(16.7%)였다. 조직 병리학적 형태는 편평상피세포암이 91.9%, 선암이 4.9%, 선편평암이 3.1%이고 골반 임파절 전이 빈도는 I기가 22.9%, II기가 31.8%였으며 전체 임파절 전이 빈도는 26.4%였다. 광범위 근치적 자궁절제술 후 방사선 치료의 빈도는 I기가 63.5%, II기가 75.8%였다. 재발율은 7.4%였고 가장 흔히 재발되는 부위는 질교합부였다. 우리는 또한 환자의 5년 생존율을 평가했는데 그 결과는 Ia기는 100%, Ib기는 95.2%(4예), IIa는 87.2%(5예), IIb는 77.8%(6예)였다. 결론: 연령별 환자의 분포는 40대와 50대가 30.9%로 가장 높은 발생 빈도를 보였고 임상 병기별 분포는 Ib기가 51.9%로 가장 많은 빈도를 보였으며 병리 조직학적 분포는 편평 상피 세포암이 91.9%로 대다수를 보였고 전체 임파절 전이빈도는 26.4%였으며 가장 흔한 재발부위는 질교합부였다. 5년 생존율은 Ia기가 100%, Ib기가 95.2%, IIa기가 87.2%, IIb기가 77.8%였다. Objective: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. Method: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. Result: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. Conclusion: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.

      • SCOPUSKCI등재

        식도의 기저세포양 펀평세포암 -1례 보고-

        박서완,정성운,이형렬,Park, Seo-Wan,Jeong, Seong-Un,Lee, Hyeong-Ryeol 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.9

        기저세포양 편평세포암(basaloid squamous carcinoma)은 상부 기도소화기계에 발생하는 드문, 악성도가 높은 암종으로 침습성 편평세포암(invasive squamous carcinoma)이나 상피내암(carcinoma in situ) 형태의 편평상피암종성분과 밀접하게 혼재되어 있는 기저세포앞종성분(basaloid component)으로 특징 지워질 수 있다. 이런 조직학적 특성에도 불구하고 식도의 선양 낭성암(adenoid cystic carcinoma)이나 선양 낭성 분화를 보이는 암종(carcinoma with adenoid cystic differentiation)과 혼동되어 왔으나, 순수 선양 낭성암은 악성도가 기저세포양 편평세포암보다 낮아감별 진단이 중요하다. 기저세포양편평세포암의 임상적 경과는 식도의 편평세포암과 유사하다. 본 병원에서는 60세 남자의 식도 중간 113 부위에 발생한 기저세포양 편굉세포암을 수술치험하였다. Basalold squamous carcinoma (BSC) is a rare, aggressive neoplasm of the upper aerodigestive tract or esophagus. It is characterized by a biphasic pattern in which basaloid tumor is intimately associated with a neoplastic squamous component which can be either Invasive r in situ. Despite its characteristic histologic appearance, the BSC of the esophagus has been confused with esophageal neoplasm variously reported as adenoid cystic carcinoma or carcinoma with adenoid cystic differentiation Their distinction is important because genuine adenoid cystic carcinoma is much less as- gressive than BSC. The biologic course of BSC is similar to that of the more frequent squamous cell carcinoma of the esophagus. We have experienced a case of BSC of the esophagus in a 60-year-old male patient. The lesion was located in the middle third of the esophagus. The patient was treated with surgery followed by radio- therapy.

      • SCOPUSKCI등재

        기관삽관후 발생한 기관식도루 -치험 1례-

        전상협,박서완,정성운,이행렬,Jeon, Sang-Hyeop,Park, Seo-Wan,Jeong, Seong-Un,Lee, Haeng-Ryeol 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.2

        후천성 기관식도루는 드문 질환이 지만 생명을 위협하는 병변이며 원인중에는 cuff가 있는 tube를 삽관하여 부적절한 관리하에 장기간 인공호흡기 치료를 한 환자에서 발생하는 경우가 가장 많다. 손상의 기전은 cutt에 의해 기관벽에 압력이 가해져서 허혈성 손상과 더불어 염증성 반응이 더해져 압박된 식도와 비정상적 교통이 생기는 것으로 여겨지고 있다. 환자는 25세된 임산부로 중이염의 합병증으로 세균성 뇌막염이 발생하여 장기간의 인공호흡기 치료중 갑작스런 피하기종과 종격동기종이 발생하여 기관지 경과 CT를 이용해 기관식도루가 발생 했음을 확인후 본과에서 수술적 치료를 시행하였다. 수술은 자동봉합기로 기관의 손상부위를 봉합하고 식도 부위는 vlcyl과 Prolene으로 내외층을 단순봉합하였으며 기관과 식도사이에 흉쇄유돌근 절편을 끼워 넣었다. 수술 후 10일째 식도조영술로 기관식도룬가 완전복구되고 식도기능이 정상임을 확인하였으며 퇴원 후 추적조사결과 환자는 별 문제없이 잘 지내고 있다. Acquired tracheoesophageal fistula, a life threatening lesion, is rare but occurs most frequently alter prolonged mechanical ven ilation using a cuffed endotracheal tube. The mechanism of injury seems to be ischemia and inflammation of compressed trachea and esophagus by cuffed endotracheal tube. The patient was a 25 years old pregnant woman who was on prolonged mechanical ventilation for bacterial meningitis secondary to untreated otitis media. 40 days after mechanical ventilation, sudden subcutaneous empysema and pneumomediastinum ocurred and these were due to tracheoesophageal fistula. It was diagnosed with bronchoscopy and CT We performed tracheal repair with TA 60mm stapler and esophageal repair by interruted two layer suture with 410 vicryl and 510 prolene. A flap of sternocleidomastoid muscle was inserted between trachea and esophagus. Postoperative course was uneventful and the result of operation was acceptable by esophagography.

      • SCOPUSKCI등재

        Spiral Vein Graft를 이용한 상대정맥 우회로 조성술-치험 1례-

        황수희,김병준,정성운,Hwang, Su-Hui,Kim, Byeong-Jun,Jeong, Seong-Un 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.3

        상대정맥 증후군을 가진 49세 여자환자에 spiral vein graft를 이웅한상대정맥 우회로 조성술을 실시 하여 좋은 결과를 얻었다. 이 복합 나선형 이식 편은 폐쇄된 상대정 맥을 우회하여 우측 무명동맥과 우심 이간에 이식되었다. 이식편은 환자 자신의 대복재정 맥을 세로로 절개하여 스탠트에 나선형으로 감은 후 정맥의 가장자리들을 봉합하여 하나의 큰직경을 가진 도관으로 만든 것이다. 환자는 증세 호전되었고 수술 후 21일째 합병증 없이 퇴원하였다. A 49-year-old female patient who had obstruction of superior vents cave(SVC) with SVC syndrome was successfully managed by bypass operation of superior vents cava with spiral vein graft. A composite spiral vein graft was placed between the right innominate vein and the right atrium to bypass the occluded SVC. The graft was constructed from the patient's own saphenous vein, which was split longitudinally and wrapped around a stent in spiral fashion and the edges of the vein were sutured together to form a large autogenous conduit. The patient was relieved o SVC obstructive symtoms and signs and discharged 21 days postoperatively without any complication.

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