불안정 협심증의 외과적 치험;11례 보고

최필조 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.5

From July 1992 through January 1993, 11 patients with unstable angina received aorto-coronary bypass surgery at Dong-A University Hospital. There were 5 males and 6 females whose age ranged from 36 to 76 years old. Of the 11 patients, 3 were Functional class IL 5 were Functional class 111.3 were Functional class IV. Preoperative coronary angiography showed a significant stenosis of the left anterior descending artery in 9 cases, of its diagonal branch in I case, of the circumfiex artery in 3 cases, and of its obtuse marginal branch in 2 cases, of the right coronary artery in 4 cases, and of left main coronary artery in 3 cases. There were 4 cases of single vessel disease, 1 double vessel disease, 3 triple vessel disease and 3 left main disease. A single graft was placed in 1 patient, a double graft in 5, a triple graft in 2, and a quadriple graft in 3 patients. Left internal mammary artery plus saphenous vein graft were used in 4 patients. Postoperative complications were mediastinitis in 1, sternal instability in 2, pneumonia in 1, arrythmia in I case.

외상성 성문하 기관 협착증의 수술 치험 1례

최필조 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.5

We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

식도암의 근치적 식도 절제술 후 폐합병증의 발생에 영향을 미치는 위험인자의 임상적 분석

최필조,정상석,Choi, Phil Jo,Jeong, Sang Seok 대한기관식도과학회 2011 大韓氣管食道科學會誌 Vol.17 No.2

Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

식도암에 있어서 Fascin의 발현과 예후와의 상관관계에 대한 연구

최필조,정상석,방정희,조광조,우종수,노미숙 대한흉부외과학회 2008 Journal of Chest Surgery (J Chest Surg) Vol.41 No.1

Backgrond: Fascin is an actin-bundling protein that induces membrane protrusions and it increases cell motility in various transformed cells. Esophageal cancer is one of the most lethal malignancies, and it exhibits extensive local invasion or frequent regional lymph node metastasis even after curative surgery. We investigate the expression of fascin by performing immunohistochemistry to evaluate the clinical characteristics and prognostic significance of its expression in esophageal cancer patients. Material and Method: Immunochemistry for fascin was performed on 76 tumor samples from 76 patients who underwent esophageal cancer operations. The expression levels of fascin in the 76 esophageal cancer tissues were compared with those in the corresponding normal esophageal epithelium. The fascin-positive samples were defined as those showing more than 75% of fascin-positive cells. Result: Overall, a fascin positive expression was detected in 39 (51.3%) out of the total 76 cases. The tumors with positive fascin expression tended to more frequently show a higher stage (p=0.030), and a higher T-factor (p=0.031). The prognosis of the fascin negative group was significantly better than that of the fascin positive group (p=0.004). Multivariate analysis revealed that lymphovascular invasion and the fascin expression were independent prognostic factors. Conclusion: Fascin was expressed in 51.3% of the esophageal cancer tissues, and a positive expression of fascin was associated with more advanced tumor progression and recurrence. Our study suggests that the fascin expression may be an independent prognostic factor for an unfavorable clinical course for those patients suffering with esophageal cancer.

원발성 종격동 종양에 관한 임상적고찰

최필조,이종수,이성광,Choe, Pil-Jo,Lee, Jong-Su,Lee, Seong-Gwang 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

Author made a clinical study of 48 cases of primary mediastinal tumors experienced in the dept. of the thoracic and cardiovascular surgery of Pusan National University Hospital during the 12 years period from march 1978 to march 1989. There were 34 males and 14 females. Their age distribution was from 4 months to 70 years, with the mean age of 34.4 years. 8.3 % of the patients were younger than 15 years old. There were teratoma 14 cases[29%], thymoma 11 cases[23%], neurogenic tumor 10 cases[21 %], lymphoma 6 cases[13 %], benign cyst 6 cases[13 %], and one case of fibrous histiocytoma in the histological distribution. The malignant tumors were 12 cases[25 %]. The common symptoms were chest pain and discomfort[35.4], coughing[18.8], general weakness and dyspnea. 16.7% of the patients were asymptomatic at admission. The successful removal was done in all cases of benign mediastinal tumors. In malignant cases, the surgical removal could be done in 5 cases. There was not postop. mortality. The frequent complications were atelectasis, infection, bleeding.

우측 쇄골하 동맥 기시이상으로 인한 연하 곤란 - 수술 치험 1례 -

최필조 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

An aberrant right subclavian artery is a rare congenital anomaly that usually does not produce symptoms. Symptomatic patients require surgical intervention. Ligation of the aberrant artery through a left thoracotomy has been advocated as the operation of choice. If development of vertebrobasilar insufficiency is anticipated, division and ligation of he aberrant artery and its anastomosis to the right common carotid artery or aortic arch are performed at a second operation. Experience with successful surgical treatment of a patient with an aberrant subclavian artery is described. A right thoracotomy incision was utilized for division of the subclavian artery and for reestablishment of arterial continuity with Dacron graft. Postoperative arteriography demonstrated a good reconstruction and normal blood flow was established to the right upper extremity.

Acriflavine-Guanosine 복합제 (AG60)가 Ehrlich 암세포를 이식한 생쥐 막창자꼬리점막상피세포의 DNA합성 및 미세구조에 미치는 영향

최필조,안의태,박경호,박대균,고정식 대한해부학회 2006 Anatomy & Cell Biology Vol.39 No.5

좌심 체외순환을 이용한 재개통된 동맥관 개존증 - 수술 치험 1례 -

최필조 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

We experienced a rare case of a recanalization and aneurysmal formation of the previously ligated PDA on 18 year-old-girl. Continuous murmur was noted 3 months after operation and this recanalization was confirmed by angiography and cardiac catheterization. It was impossible to mobilize aneurysmal PDA with safety, so we closed the defect using left heart bypass to prevent spinal card injury. Postoperative course was uneventful and the patient was discharged in good condition.

우측 소매 전폐 적출술 후 발생한 기관 협착증의 체외 순환을 이용한 수술치험 1례

최필조 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.4

Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

Femoro-femoral bypass를 이용한 우측 sleeve pneumonectomy 치험 1례

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

We report a successful right,sleeve pneumonectomy using femoro-femoral bypass on a 26-year-old woman with severe carinal and lower tracheal stenosis of tuberculous origin. Omental graft on the anastomotic site was added, There was no specific postoperative complication and postoperative bleeding was minimal.