급성 백혈병에 병발한 괴사성 맹장천공

정풍만,고영혜 대한외과학회 1987 대한외과학회 학술대회 초록집 Vol.1987 No.11

Peutz-Jeghers 증후군의 외과적 고찰

정풍만,이석현 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6

pigmentation and gastrointestinal hamartomas. Hamartomas are not generally regarded to be premalignant, but in the Peutz-Jeghers syndrome a number of authors have found the existence of malignancies in hreast, gonad as well as gastrointestinal tract. We studied 11 cases of Peutz-Jegher. syndrome admitted at Department of Surgery of Hanyiang University hospital and acquired the following results: The age ranged from 3 years old to 44 years old, with average age 16 years old. All patients had had mucocutaneous pigmentation since early infants, repeated episodes of abdominal pain due to intussusception, occult blood loss from the intestinal traqt, and anemia are main symptoms. Eight cases out of 11 cases had family history. The polyps distributed as follows: Jejunum (11 cases, 100%), ileum (9 cases, 81.896), colon (9 cases, 81. S), stomach (4 cases, 36.44), and duodenum (3 cases, 29. 3%). Colonic adenocarcinoma develqped in a 44 years old man. The development of malignancies in breast, gonad as well as gastrointestinal tract and recurrnce of polyps in GI tract required regular follow-up study.

제32차 학술대회 : 143. Hemithyroid and Thyroglossal Duct Cyst

정풍만 () 대한외과학회 1980 대한외과학회 학술대회자료집 Vol.- No.-

소아 영역의 소화성 궤양에 대한 임상적 고찰

정풍만,박인철,김남수,이항 대한외과학회 1992 대한외과학회 학술대회 초록집 Vol.1992 No.11

담도폐쇄증과 신생아 간염의 감별진단

정풍만,이종인 대한외과학회 2001 대한외과학회 학술대회 초록집 Vol.2001 No.11

Siver Sulfadiazine의 화상 국소치료 효과에 관한 연구

정풍만 漢陽大學校 1979 論文集 Vol.13 No.-

Sepsis is a severe complication of thermal burn wounds. During the last several years broad spectrum antimicrobials have been applied to burn surface to inhibit the bacterial flora and minimize the incidence of sepsis. Topical treatment of burn wound with 0.5% silver nitrate and sulfamylon have reduced the morbidity and mortality but have such drawbacks as the technical and economic problems of maintaining fresh wet soaks, the frequent development of bacterial resistance, pain on application, and disturbance of electrolyte balance. In 967, Charles L.Fox, Jr. symthesized the drug silver sulfadiazine (AgSD) by combining silver nitrate and sodium sulfadiazine. thus the bastericidal action of silver is combined with the bacteriostatic effect of sulfonamide, and as such, is lethal to many organism, particularly pseudomonas aeruginosa. We have investiagted clinical experiences of 1% silver sulfadiazine as a topical and antibacterial agent for the prevention of burn wound in 38 patient6s who were admitted at Department of Surgery, Han Yang University Hospital from September 27, 1976 to February 23, 1977. Twenty four patients out of the 38 patients we could obtain the bacteriological study from burn wound swab and tissue biopsy cultures. Bacterial culture was performed in sheep blood agar on the postburn 1, and the succeeding days. The results obtained are as follows: 1) A once-daily application of 1% silver sulfadiazine by open method is superior to occlusive dressing because close observation and easiness of treatment and early active exercise during hydrotherapy. 2) Applicant on on burn surface has been virtually painless aud not black stainable. 3) The easchar softens and gradually disengages without infection. 4) Superficial second-degree burns epithelize in ten days. and Deeper burns at two to four weeks are found coverd with usually sterile eschar or exudate and through which islands of epithelium can be seen. 5) No systemic toxicity and any metabolic and respiratory abnormality are noted. 6) Serial bacteriology obtained by burn wound biopsy and surface swab, no micro organism are cultured in 18 patients, but Pseudomonas aeruginosa is cultured in 6 patients among 24 patients, one of these has mixed infection with E.coli. 7) Three of these six Pseudomonas infected wounds become sterile on 7, 11, 15 postburn day. 8) Mortality due to Pseudomonas sepsis occurred in three patients among thirty-eight patients.

담도폐쇄증 의심하에 수술을 위해 전원된 환자의 임상 경과 분석

정풍만,이종인,Jung, Poong-Man,Lee, Jong-In 대한소아외과학회 2001 소아외과 Vol.7 No.2

Biliary atresia (BA) is very difficult to distinguish from neonatal hepatitis (NH) and its prognosis depends on the age at the time of Kasai operation. Therefore early differentiation between these two conditions is very important. Although various clinical and laboratory tests have been reported to differentiate between them, they are still of limited value. From 1980 to 1999, forty-five infants were referred to our pediatric surgical unit for operation for suspected BA. Eight patients underwent Kasai operation immediately because of late diagnosis. These were excluded from the study. The clinical history, physical findings. radiologic and laboratory examinations of 37 cases were analyzed retrospectively. The average age of BA (n=20) was $55.1{\pm}16.7$ days, and that of NH (n=17) was $55.8{\pm}15.6$ days. The sex ratio of BA was 13:7, and that of NH was 14:3. All the patients had obstructive jaundice and acholic stool except 4 BA and 6 NH patients. Acholic stool with yellow component was more frequent in NH. Onset of jaundice was within 2 weeks after birth in 85 % of BA, and in 65% of NH. The onset of acholic stool was within 2 weeks after birth in 60 % of BA, and in 23.5 % of NH. The duration of jaundice and acholic stool of BA were $50.9{\pm}16.6$ days and $41.3{\pm}18.4$ days and those of NH were $40.1{\pm}23.1$ days and $26.6{\pm}25.4$ days respectively. The ultrasonogram and hepatobiliary scan were useful, but not a definitively reliable method for the differentiation of these two diseases. There was no difference in laboratory data. Seventeen cases had NH among 45 referred cases for Kasai operation with the clinical impression of BA, and 4 cases of 17 NH cases needed to be explored to rule out BA. In conclusion. false positive rate of clinical impression of BA was 37.8 %. and negative exploration rate was 8.9 %, Therefore. careful clinical observation for 1-2 weeks by an experienced pediatric surgeon was very important to avoid unnecessary operation to rule out NH up to the age of 8 - 10 weeks. so long as the stool had yellow component.

소아의 감돈 서혜부 탈장

정풍만,서정민,Jung, Poong-Man,Seo, Jeong-Meen 대한소아외과학회 1995 소아외과 Vol.1 No.2

Three hundred and twenty-seven patients of 2,046 inguinal hernia cases Primarily repaired at Hanyang University Hospital had the history of incarceration or presented as incarcerated inguinal hernia on admission. Incidence of incarceration of all male hernias was 14.2%(234 patients) and 22.7%(93 patients) of all female cases. Incarceration occurred in 17.3% of all right hernia cases and in 13.7% of all left hernia cases. The incarceration occurred 52.6% of the hernia patients in the first month of life, 27.3% in the first year, 26.7% in the second year and 7.8% after 2 years of age. Strangulated inguinal hernia occurred in 8 patients: five patients had ovaries involved, two patients intestines, and one patient omentum. Emergency operations were performed on 66 patients(20.2%) because incarcerated hernia could not be reduced by taxis. At the time of operation, the hernia sacs were empty in 140 of 327 patients and the remainders contained omentum(50), small intestine (44), appendix and/or cecum(28), sigmoid colon(2), ovary and/or tube(66), and omental cyst(1). An elective hernia repair should be performed promptly after presentation of the hernia, especially before 2 years of life because of high incidence of incarceration. In this study, of 327 incarcerated hernia, 187 patients(57.2%) did not have prior history of incarceration and incarceration developed more than 7 days after hernia onset in 95.6%. If the hernia repairs had been performed within 7 days after hernia onset, about half of the incarceration might have been prevented.

소아의 음낭수종과 Nuck 수종

정풍만,Jung, Poong-Man 대한소아외과학회 1996 소아외과 Vol.2 No.1

Clinical experiences of 833 hydrocele children presented at Hanyang University Hospital, of whom 456 children were operated by one pediatric surgeon from September 1979 to December 1993, were analyzed. Eight hundred and twenty three children were boys(right 476, left 279, bilateral 49, and unknown 19), and 10 were girls(8 right and 2 left). Operation was performed on 446 boys and all girls. Of boys diagnosed before the age of 6 months, 15.6% was operated and 68.7% of those after 6 months of age was operated. Among the boys operated after 2 years old, 16.5% had had hydrocele before 6 months of age, 20.4% before 1 year old and 34.6% before 2 years old. On the other hand, 28.8% of boys diagnosed after 2 years of age did not undergo hydrocelectomy. Sixteen children with hydroceles had contralateral hernias at the same time. After repair of unilateral hydroceles, contralateral hydroceles developed in 7 and hernias in 3 children. After disappearance of unilateral hydroceles, it reappeared at the same site in 4 and contralateral hydroceles or hernias developed in 2 children each. Hydroceles converted to hernias in 6 children before treatment. Hydroceles developed after ventriculo-peritoneal shunt in 5 children. The pathophysiology of hydrocele and inguinal hernia seems to be the same because of the similar distribution of onset age between them but hydrocele has various clinical courses. The results that 34.6% of boys operated after 2 years old had had hydrocele before 2 years of age and 28.8% of boys diagnosed after 2 years old did not undergo hydrocelectomy could not imply the proper age when hydrocelectomy could be performed. But operative repair of hydroceles after the age of 6 months seems to be recommendagle.

소아 기형종의 임상적 분석

정풍만,이종인,Jung, Poong-Man,Lee, Jong-In 대한소아외과학회 1999 소아외과 Vol.5 No.1

Among 60 children with teratoma, forty-three (71.7 percent) were girls and 17 (28.3 percent) boys, Primary sites were sacrococcygeal in 30 patients (50 percent), retroperitoneal in 12 (20 percent), ovarian in 11 (18.3 percent), testicular in 3 (5 percent), and one in each of nasopharyngeal, gastric, hepatic and pancreatic (1.6 percent, respectively). Fifty-five (91.7 percent) teratomas were benign and 5 (8.3 percent) malignant. Malignant teratomas W8,re detected only in the sacrococcygeal region (16.7 percent). Age greater than 2 mouths at diagnosis, presence of urinary or colonic obstructive symptoms, multiple masses and elevated serum alpha-fetoprotein were indicators of malignancy in the sacrococcygeal region. Tumor size, presence of calcification, and gross apperance (cystic or solid) did not correlate with malignancy. Thirteen (21.7 percent) cases were associated with other anomalies. For the immature teratoma, operative resection without adjuvant chemotherapy was adequate treatment. Three patients with malignant tumors survived, one who received chemotherapy survived 3 years and the others without chemotherapy survived for 5 and 10 years.