기관지 재건술

池幸玉 대한의학협회 1994 대한의학협회지 Vol.37 No.8

박리성 대동맥류

池幸玉 대한의학협회 1992 대한의학협회지 Vol.35 No.12

흉부외상환자에서 응급치료를 요하는 질환

池幸玉 대한의사협회 1996 대한의사협회지 Vol.39 No.10

나보다는 우리를

지행옥 대한결핵협회 1994 보건세계 Vol.41 No.3

심장혈관수술 1597례에 대한 임상적 고찰 (개심술 ,1005례 보고)

지행옥 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.3

1,597 cases of operation on the cardiovascular disease were performed at the Hanyang University Hospital from 1972 to 1987. Of these, 1,005 cases were open heart surgery. It was started from July 1975. Among the open heart cases, 725 were congenital heart diseases and 280 were acquired heart diseases. In congenital heart cases, 554 were acyanotic and 171 were cyanotic. The operative results were as follows; the overall mortality of cardiovascular surgery was 7.1%, the open heart mortality was 9.5%. This analyses were reported in memory of the achievement of 1,000 cases of open heart surgery.

생선뼈'에 의한 식도천공의 외과적 치료: 4례 보고

지행옥,김근호 대한흉부심장혈관외과학회 1973 Journal of Chest Surgery (J Chest Surg) Vol.6 No.1

This is a report on a total of four cases of esophageal perforation due to fish bone in the Department of Thoracic Surgery, Hanyang University Hospital. The perforated portions of esophagus were upper third of esophagus, that is, cervical esophalgus principally. The complications after esophageal perforation were acute mediastinitis with mediastinal emphysema in 2 cases, acute mediastinitis with both pyothorax in one case and cervical subcutaneous abscess alone in one case. Collar mediastinostomy was required to control disturbance of cardiopulmonary function as emergency procedure. Gastrostomy was of worthy for the various purposes, that` is, for feeding, absolute rest of the esophagus, and for prevention against continuous infection from esophageal leakage. After the gastrostomy. 3 cases were healed by spontaneous closure of esophageal perforation between one to four weeks. One case expired from severe septic shock due to acute diffuse mediastinitis and both pyothorax.

양성 종격동종양의 외과적치료에 대한 임상적 고찰

지행옥 대한흉부심장혈관외과학회 1970 Journal of Chest Surgery (J Chest Surg) Vol.3 No.2

This is a report on a total of 8 cases of benign mediastinal tumors and cysts in Department of Thoracic Surgery, Chonnam University Hospital during the period from 1961 to 1969. The patients age was distributed between 18 and 38 year old with the highest incidence in the age group of second decade. Sex ratio of male to female was 3: 5. The tumors were classificed as follow; 3 case:, of neurogenic tumors, 2 cases of teratomas, one case of pericardial cyst, one case of cystic hygroma, and one case of brochogenic cyst. The symptomatic patients were 5 cases(62. 6%) and asymptomatic patients were 3 cases(37.5%). The symptomatic patients had the symptoms not referable to their lesion and the mediastinal tumors of asymptomatic patients were incidently found by routine chest X-ray. The Symptoms occurred by compression to adjacent nerve system in 3 cases. by perforation into the lung with infection in one case and by infection of bronchial cyst in one case. The complications were Pancoast's syndrome including Horner's syndrome(2 cases), middle lobe syndrome (one case), bro:1chial infection(one case) and intercostal neuralgia(one case). All tbe tumors were surgicai[y resectable with good recovery postoperatively. In 5 cases of the symptomatic patents, their symptoms were disappeared dramatically after operation.

각혈을 동반한 결핵성 농흉 및 기관지늑막루의 환자에서 늑막 및 전폐절제술후 다량의 출혈환자의 치험 1례

지행옥 대한흉부심장혈관외과학회 1989 Journal of Chest Surgery (J Chest Surg) Vol.22 No.5

There appears to be significant problems remained in the treatment of tuberculous empyema with BPF in spite of several surgical methods: decortication, thoracoplasty, and pleuropneumonectomy. We presented one case of tuberculous empyema with BPF. The patient was 42-year-old male and his chief complaint was hemoptysis. In past history, he was treated with left closed thoracostomy and antituberculous medication for two months, 16 years ago. Chest X-ray, tomogram and C. T, revealed a huge mass with central necrosis in the lower 2/3 of left thoracic cavity and shifting of the mediastinal structure to the right. Needle aspiration cytology was undifferentiated large cell carcinoma. Left thoracotomy was made under the impression of lung cancer and pleuropneumonectomy was done. Operative findings; thick walled empyema sac filled with hematoma and BPF, the mediastinum was fixated due to fibrosis and calcification of the pleura and the mediastinum. Postoperative biopsy was consistent with tuberculosis. In the postoperative course, there was massive hemorrhage and so reoperation was done. But there was no active bleeding focuses in the thoracic cavity at the time of reoperation. Massive transfusion, coagulant therapy and intermittent clamping and declamping of the chest tube were carried out. Especially, serum calcium level was chronically decreased and so large amount of calcium gluconate was infused for the calcium level to be normal. Total transfused blood; whole blood was 33 pints, packed cell was 63 pints and fresh frozen plasma was 70 pints. At the postoperative[reop] 45th day, intrathoracic hemorrhage was stopped and the chest tube was removed. In conclusion, this suggest that uncontrollable bleeding after pleuropneumonectomy of the tuberculous empyema with BPF could be treated without reoperation in case of the mediastinal fixation due to fibrosis and calcification of the pleura and the mediastinum.

家兎腦室 上衣細胞에 依한 追跡物質의 輸送에 關한 電子顯微鏡的 硏究

池幸玉 全南大醫大 1974 전남의대학술지 Vol.11 No.4

Hartmann`s 용액으로 충진한 혈희석 체외순환에 관한 실험적 연구: (1보: 심폐기 Rygg-Kyvsgaard 의 혈산화와 혈압 및 혈액상에 미치는 영향)

지행옥 대한흉부심장혈관외과학회 1971 Journal of Chest Surgery (J Chest Surg) Vol.4 No.2

Total body perfusion using Rygg-Kyvsgaard Heart-Lung-Machine, Mark IV, Polystan was attempted in the dogs by the hemodilution method with total prime of buffered Hartman's solution and under hypothermia. The first of all, the functions of Rygg--Kyvsgaard Heart-Lung-Machine and the effects of the hemodilution perfusion by buffered Hartman's solution was studied. At the same time the changes of blood pressure, oxygen consumption, and influence on the blood pictures were observed before, during, and in 1-3 days after perfusion. Hemodilution rates were the average 74. 22cc/Kg(the ranges of 67 to 81 cc/Kg) and perfusion flow rates were maintained in the mean 62. 6cc/Kg/min., Although it was possible to check up to 87 cc/ Kg/min. The total body perfusion continued for 60-80 minutes. Hypothermia was employed between $36^{\circ}C$ and $32^{\circ}C$ of the rectal temperature. Arterial pressure was ranged approximately between 68mmHg and 149mmHg, but generally, it was maintained over 80mmHg. Venous pressure was measured between 6.5cm $H_2O$and 11.5cm $H_2O$. Optimum oxygenation can be expected when oxygen flow into the disposable bubble oxygenator was maintained approximately at 3.5 L/min .. Inthis way, the oxygen contents were measured in the mean value of 13.11${\pm}$O.56 vol. % of arterial blood and 8.67+1.08 vol.% of venous blood(P<O.OO1). Under this condition. 4.78${\pm}$0.86 vol.% in arteriovenous oxygen difference and 2. 97${\pm}$0.62cc/Kg in oxygen consumption were calculated. According to these dates, it is as plain as pikestaff that excellent oxygenation and good tissue perfusion was accomplished. Erythrocyte, hemoglobin and hematocrit were decreased about 38% during extracorporeal circulation and these were not recovered until 1-3 days after perfusion. These decrease was resulted from relatively high degree of hemodilution rate and no blood transfusion to compensate during these experimental studies. The platelets were also decreased about 76% during perfusion, but on the contrary, it was increased progressively after perfusion and in 1-3 days after perfusion was returned to the control level. Leucocyte were also decreased during perfusion, but it was increased progessively after perfusion and in 1-3 days after perfusion exceed the control level. This increase was resulted from postoperative infection of the wound, but its analysis were not changed significantly.