內氣管支 過誤腫

최용만 梨花女子大學校 醫科大學 醫科學硏究所 1981 EMJ (Ewha medical journal) Vol.4 No.1

Pulmonary chondromatous hamartoma is a very rare disease in pulmonary tumors but it's character is benign nature. It is often incidental, asymptomatic finding on routine chest roentgenogram. They are reported to account for 8 percent of all coin lesions. In 1904, Albrecht first used the term "Hamartoma" to refer to a cogenital abnormal mixing of the normal components of an organs other than the lung. The author experienced one case of endobronchial hamartoma. The patient, 41-year-old-female was admitted to our hospital due to chest tightness and general weakness. Chest roentgenogram reveals that walnut-size radioopaque density is seen in right upper lung field with demarcated margin. Right pneumonectomy is performed and the answer of pathology is benignendotrachial hamartoma. The post-operative course is unevenful and she was discharged in good condition.

火傷患者 282例에 關한 臨床的 考察

崔龍萬 梨花女子大學校 韓國生活科學硏究院 1978 韓國生活科學硏究院 論叢 Vol.21 No.-

1971年 1月부터 1976年 12月까지 滿 6年間 梨花大學病院 外科에 入院加療한 火傷患者 282例의 臨床的 考察 結果 1.4:1로 男者가 많았고, 小兒患者 特히 1∼5歲의 scalding burn이 家庭內에서 發生된 境遇가 가장 많아 父母들의 細心한 注意로 이들의 火傷을 막아야 됨이 强調되었고 4季節에 고루 發生되었으나 野外行樂이 極에 이르고 겨울이 始作되는 10月이 많았다. 火傷原因은 scalding burn이 가장 많았고 2/3以上이 24時間內 入院하였으나 充分한 治療를 받지 못하고 經濟的 理由로 10日 以內에 退院하는 患者가 많아 醫療保驗의 擴大가 바람직하였으며, 火傷의 深度는 2度火傷이 많았으나, 範圍가 41% 以上인 火傷은 3度火傷이 많았다. 火傷의 範圍는 10% 以內가 가장 많았고 다음으로 11∼20%, 21∼30%의 순이었으며 火傷部位는 下肢와 上肢에 많았고 scalding burn은 下肢와 同體에, flame burn은 頭經部와 上肢에 많았다. 13.8%에서 皮膚移植을 實施하였고 그 時期는 3∼4週가 가장 많고 다음이 2週 以內로서 皮膚移植이 必要한 患者는 좀 더 일찍 이를 施行해야 할 것으로 나타났고, 火傷의 合倂症으로는 創傷感染이 가장 많았고, 다음은 尿路感染이었으며, 昌傷感染菌은 pseudomonas aeruginosa가 가장 많았고 Candida albicans도 培養되고 嚴格한 抗生劑의 選擇과 投與가 要求되었다. 死亡率은 7.8%로 比較的 낮았는데 이는 小範圍 火傷이 많고 10日 內 退院하는 境遇가 있었으며, 水液 및 抗生劑療法의 開發때문인 것으로 解釋되었다. 死亡者의 2/3가 小兒患者였고, 61% 以上의 火傷은 거의 死亡하였으며, flame burn과 3度火傷의 死亡率이 높았던 것으로 보아 major burn을 治療하는 데는 burn center나 specialist가 꼭 必要할 것으로 생각되었다. A total of 282 burn patients who were admitted to the Surgical Department of Ewha Womans University Hospital during the past 6 years, from Jan. 1971 to Dec. 1976, were clinically reviewed. Home indoor scalding burns and mortality due to it of 1-5 year old children were most abundant. So, it was determined that parents must pay more attention to their children. More careful administration of antibiotics was requested because of wound infection by pseudomonas aeruginosa, the most frequent compli-cation of burns. Candida albicans was cultured in 3 cases. The skin graft should be performed more early. The following results were obtained: (1) The sex incidence revealed a prevalence in males, with a ratio of 1.4 male to 1 female. (2) The age distribution revealed that children were most abundant(48.6%), and the 1-5 year old age group was most predominent(33.7%) among them. (3) Seasonal distribution revealed no significant difference, but Summer was more frequent, and October most abundant in monthly distribution. (4) Most of the burns occured in the home(74.5%). (5) Scalding burns(58.9%) and flame burns(33.7%) were the most common causes of burns. (6) Many of burn patients(71%) were admitted within 24 hours. (7) In burn wound depth, 2nd degree burns(68.5%) were more abundant than 3rd degree burns(40/85). (8) The extent of the burn was most prominent within 10% of body surfa‘ next, 11-20% of body surface(13.8%). In relationship to the depth and extent of the burn, 3rd degree was more abundant above 41% of body surface. (9) Burn wounds were most predominent in the lower and upper extrimities. In scald-ing burns, the lower extrimities and trunk were more prominent, while the head, neck and upper extrimities were more prominent in flame burns. 1(0) More commonly, burn patients were hospitalized within 10 days(59.6%). (11) Occlusive dressing was the most common(69.3%). Furazin ointment was the most commonly used local agent, and gentamycin cream was next. (12) Skin graft was performed on 39 patients(13.8%), and it was most commonly per-formed during 3-4 weeks. 1(3) The main early complications were wound infection(27.3%), and genitourinary infection(7.5%). (14) The main organisms found in wound cultures were Pseudomonas aeruginosa(45.9%), and Staphylococcus (34.1%). Candida albicans was cultured in 3 cases. (15) The mortality rate was 7.8% and the causes of death were septic shock, pulmonary complication, renal shutdown, U.G.I. bleeding and hypovolemic shock. 1(6) The most predominent age of death was in the 1-5 year old group/68.2%). Deaths were more common in flame burns and 3rd degree burns. Almost all of burn patients with burns over 61% of body surface expired.

小兒 腸重疊症의 臨床的 考察

崔龍萬 梨花女子大學校 韓國生活科學硏究院 1979 韓國生活科學硏究院 論叢 Vol.23 No.-

1973년 8월1일부터 1978년 8월 말까지 만 5년간 이화여자대학교 부속병원 외과에서 치료한 장중첩증환자 62에를 가지고 임상적 및 통계적 분석을 하였다. 장중첩증은 소아의 급성복증 중 가장 흔한 질환이며, 조기에 진단하여 적절한 치료를 함으로써 100%의 완치가 되는 질환이다. 62예를 가지고 연령 및 성별분포, 발병후 내원까지의 기간, 계절별 빈도, 발병원인, 임상증상 및 증후, 검사소견, 방사선소견, 유형별 분포, 치료 및 합병증에 대한 것을 비교 검토하였다. 고찰의 결과 장중첩증은 남아에서 1세 미만에 주로 발병하여 발병되고나서 대부분 24시간 이내에 병원에 오는 것이며, 호흡기 질환이 많은 겨울철에 장중첩증이 많이 발생한다는 연관성을 알게 되었고, 병의 원인은 특발성이며, 이 병의 삼대증상 및 증후군을 대부분 나타내고 있으며,ㅣ ileocecal type이 가장 흔한 형이며, 대부분 수술요법으로 완치가 되었다. Intussusception is the most important and frequent surgical disease in infancy and childhood. This clinical studt was performed on 62 cases with intussusception who were admitted to the Department of surgery, Ewha Womans University Hospital for the past 5 years from August 1973 to August 1978. The following results were otained: 1) In age distribution, the peak incidence was bwtween 6 months and 9 months of age. 51 cases(82.3%) were under one year of age, and the malw tp female ratio was about 3.81:1;males were more affected than females. 2) 40cases(64.5) visited our hospital within the first 24 hours following the onset of symptoms 3) The seasonal distribution showed peaks in summer(25.8%), and the least in autumn(12.9%). 4) The etiology was idiopathic in all cases. 5) The cardina; symptoms and signs were vomiting (90.3%), current jelly stool(85.5%), irritabillty(67.7%) and palpable mass(64.5%). 6) Nimber of W.B.C was most frequent within 10,000~15,00/Cu.mm(46.8%). 7) In the X-ray study, intestinal obstruction signs were manifested in 83.7% with olain abdominal conditions, and intussusception signs were manifested in 89.5% with barium enema. 8) The most common type of itussusception was ileocecal type(48.4%) 9) In the treatment, surgical procedure was performed on 80.6%, of which manual reduction was the most frequent with 86%. Barium reduction was successful in 63.2% of the cases. 10) Among cases admitted to our hospital within 24 hours after the onset of symptoms, postoperative complications occurred in 24% of the cases, with an overall moratlity rate of 3.2%.

간내 담석증의 임상적 고찰

최용만 梨花女子大學校 醫科大學 醫科學硏究所 1990 EMJ (Ewha medical journal) Vol.13 No.4

The hepatobiliary stone is one of the most common surgical disease in Korean population, and intrahepatic stone is found in 9~22% of the biliary calculous disease in Korea. A retrospective clinical study was done in 25 cases of intrahepatic stones who underwent operation in Ewha Womans University Hostpital during from Jan. 1986 to Sept. 1990 The result obtained are follows : 1) The incidence of intraphepatic stones to all gall stones during the period was 12%. 2) The incidence of sex was slightly predominent in famale than male with the ratio of 1 : 1.3. The peak age incidence was 4th decade. the mean age was 51.8 years old. 3) Left intrahepatic duct stones were found in 9 cases(36%), right intrahepatic duct stones were found in 4 cases(16%), both intrahepatic duct stones were found in 4(16%) cases. 4) Subjective symptoms were RUQ pain, jaudice, and fever and chills. 5) The most valuable diagnostic methods were endoscopic retrograde cholangiopancreatog. ram(ECRP), percutaneous transhepatic cholangiogram(PTC), computed axial tomography(CT) and abdominal sonography. 6) Operative procedures underwent, left lobectomy and segmentectomy in 9 cases, choledochojejunostomy or choledochoduodenostomy in 14 cases. 7) Post operative coplication was 3 cases (12%) of subphrenic abscess, 1 cases(4%) of septicenmia and wound infection. In conclusions, the valuable diagnostic methods of intrahepatic duct stones are ERCP, PTC, abdominal sonography and CT. The hepatic lobectomy or segmentectomy is the best procedure for intrahepatic duct stones.

간외 담도암의 외과적 치료

崔龍萬 대한의학협회 1994 대한의학협회지 Vol.37 No.4

일반외과에서의 통원수술

崔龍萬 대한의학협회 1993 대한의학협회지 Vol.36 No.2

급성 담낭염으로 인한 다발성 담낭파열

최용만,최금자 中央醫學社 1976 中央醫學 Vol.30 No.4

Although rare perforation of the gall bladder is associated with high mortality. Perforation of the gall bladder is usually a consequence of acute cholecystitis with gangrene but occasionally results from other special conditions such as typhoid. One of the early classical articles on the subject of perforation of the gall bladder is by McWilliams(19I2). Strohl et al. reported an incidence of perforation in acute?cholecystitis of about 8 3 percent, and Glenn cites a mortality rate of from 5.8 to 75 percent; with an average 25.5 percent. Therefore, early or emergency operation for acute cholecystitis has been advised by many authors to avoid this mortality. This recommendation is justified since mortality and morbidity of, holecystectomy are low (1 to3 per cent). Also, mortality rates of emergency or early cholecystectomy and elective operation, appear to be the same. Authors are about to report two cases of spontanenous multiple perforation of gall bladder due to acute cholecystitis in one 58 year old female and the other 54 year old female in which the patients made recently a complete recovery following a surgical removal of the perforating gall bladder and abdominal drainage with massive antibiotics.

胃平滑筋肉腫1例 : Report of One Case

崔龍萬 梨花女子大學校 醫科大學 醫科學硏究所 1979 EMJ (Ewha medical journal) Vol.2 No.1

The incidence of the leiomyosarcoma is 1~3% of all gastric malignant tumors and 20~25% of all gastric sarcoma. It is hard to differentiate between the benign leiomyoma and leiomosarcoma by gross finding, radiologic studies and endoscopic studies, even microscopically. The main symptoms and signs are epigastric discomfort or pain, palpable mass, bleeding and anemia, weight loss and anorexia. The prognosis of the leiomyosarcoma is better than carcinoma or other sarcoma such as lymphosarcoma. In Surgical Department, College of Medicine, Ewha Womans University, author had experienced one case of leiomyosarcoma confirmed by microscopically in 32 years old female patient, which was located in the antrum of the lesser curvature and type was endo-exogastric type. Operative procedure was made subtotal gastrectomy. I intend to report this case with review of the literatures.

경부 종류의 임상통계적 고찰

崔龍萬 梨花女子大學校 韓國生活科學硏究院 1977 韓國生活科學硏究院 論叢 Vol.19 No.-

경부의 종류는 어느 연령층에서나 이학적 소견상 흔히 발견되는 질병 또한 증상이지만 그 원인은 다양하며 조직학적 검사를 시행하지 않고서는 그 진단이 어려운 경우가 많다. 특히 경부의 임파 관계는 두안부 및 경부 자체 기관들로부터의 주입은 물론 상지와 흉부로부터 주입되는 경로와 더욱이 좌측에서는 Thoracic duct를 통한 복부 장기로부터의 경로 등으로 인하여 종류의 전이성 종양이 관찰될 수 있다. 이렇게 다양한 경부 종류에 대하여 구미에서는 부분 또는 총괄적으로 연구된 바가 많지만 아직도 우리나라에서는 이에 대한 총괄적인 연구 검토가 거의 없는 실정이다. 이에 저자는 우리나라의 경부 종류에 대한 총괄적 연구 검토 내지 특이성을 보기 위한 일환으로서 이화여대 부속병원에서 1970년부터 1975년까지 만 6년간 조직학적 생검에 의하여 진단이 확정된 530예에 대해서 임상적 고찰을 하였던 바 우측 일측성에 염증성 종류가 반수였음을 발견하였다. Neck mass was easily found on inspection and palpation but exact diagnosis was made only by histologic examination. A clinical review for 530 cases of neck mass was made during the six years from January 1970 to December 1975 at Ewha Womans University Hospital. Following results were obtained: (1) Histopathologically there were 14 cases in congenital lesion, 345 cases in inflammatory lesion, 151 cases in benign tumor, 13 cases in primary malignancy and 6 cases in metastatic malignancy. (2) The highest age incidence was in the group of 20~29 years (30.0%), and the sex ratio of male to female was 1:2.6. (3) In inflammatory lesion the age incidence was most high in 20~29 years (33.8%) with the sex ratio of male to female, of 1:7.9. (4) The unilateral lesion was 71.3%, bilateral 12.1%, and midline 16.6%. In the unilateral mass the lesion of the right side were than multiple(1:3.3)in cases. (5) Most frequent inflammatory lesion was nonspecific lymphadenitis and also most frequent benign tumor was thyroid adenoma. (6) Most common disease was nonspecific lymphadenitis in the unilateral and bilateral lesions but benign thyroid adenoma in the midline lesion.

체외충격파분쇄기가 실험동물의 담석 및 장기에 미치는 영향

최용만 梨花女子大學校 醫科大學 醫科學硏究所 1989 EMJ (Ewha medical journal) Vol.12 No.4

Since extracorporeal shock waves lithotripsy in urinary tract has been proved successful, it leads to extend the technology to the treatment of gallstones. Before preliminary clinical application of extracorporeal shock wave lithotripsy for gall stone, I evaluated the effects of Extracorporeal SD-3 lithotripsy on the various abdominal organs of the dogs and its efficacy on experimentally induced cholelithiasis in the same species. In spite of a limited number of observation, the high energy shock wave was not serious complication of abdominal organs, and experimentally induced gall stone in the dogs seems to be effectively fragmented and tolerated in the composition of cholesterol stone, but not effect in pigment stone. In conclusion, the biliary lithotripsy with extracorporeal shock wave may be a useful treatmental method if applied in selected cases and it should be opened for further study in larger experimental group.