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양기민 대한흉부심장혈관외과학회 1971 Journal of Chest Surgery (J Chest Surg) Vol.4 No.1
37 years old female was admitted with chief complaints of dyspnea on exertion and hemoptysis. Past history and family history were non-contributory. Physical examination showed Grade III systolic murmur at the apex, which transmitted to the back. E. K. G. and X-ray findings were compatible with the mitral insufficiency. With small size of Beall mitral valve, mitral valve replacement was done under the cardia-pulmonary bypass using hemodilution technic. Patient was tracheotomized after operation and assisted respiration was done for four weeks. Postoperatively, all signs were fine and patient walked around the ward without any difficulty, but she was in psychotic state. On postoperative 60th day, she complained of sudden dyspnea and on chest film, tracheal stenosis was found and recannulation of the tracheal tube was made. Thereafter, she was quite fine until postoperative 110th day when she, by berself, removed the tracheal cannula and died of asphyxia. Autopsy findings of the valve showed no thrombosis, no variance of the valve, and good endothelization of the valve cuffs. Asphyxia, due to removal of the tracheal connula by herself under psychotic state, was considered to be the cause of death in this patient who had tracheal stenosis after tracheostomy.
Intralobar Pulmonary Sequestration: 수술 1예 보고
양기민,안긍환,김용일 대한흉부심장혈관외과학회 1971 Journal of Chest Surgery (J Chest Surg) Vol.4 No.1
Intralobar pulmonary sequestration is rare congenital lung disease, in which systemic artery supplies a congenitally cystic portion of the lung. Patient was 19 years old male whose complaints were fever, chest pain and sputum. Chest film showed a round homogenous density and air-fluid level at the left lower lung field and on bronchogram, contrast materials did not enter the abscess pocket. By operation multiple lung abscess pockets at the lower lobe were noted. An aberrant artery, measuring 0.4cm. in diameter and 2 cm. in length, arised from the aorta just above the diaphragm and entered the pusterior basal segment of left lower lobe. After division of the artery, left lower lobectomy was done ana postoperative hospital course was uneventful. Pathologic findings were multiple lung cysts which were not connected to the left lower lobe bronchi and an aberrant artery which showed elastic lamillation and mild sclerotic change.
양기민 대한흉부심장혈관외과학회 1977 Journal of Chest Surgery (J Chest Surg) Vol.10 No.2
Superior vena cava to pulmonary arterial shunting operation was made between the superior vena cava and the right pulmonary artery in the fashion of end-to-end anastomosis in 20 mongrel dogs. The experimental animals were divided into three group and blood flow in the superior vena cava was occluded for 20, 30 and 60 minutes respectively, and observations were made for the changes in caval pressure and cerebrospinal fluid pressure. And pathologic examinations were also performed. On occluding the caval blood flow, the superior vena caval pressure was sharply and immediately elevated from $103.5{\pm}19.8mmH_2O$ at thoracotomy to $556.4{\pm}86.lmmH_2O$ within 2 minutes to make its plateau thereafter, and the cerebrospinal fluid pressure followed closely the changes of the superior vena caval pressure in its level and pattern being elevated from $102.0{\pm}19.9mmH_2O$ to $490.5{\pm}79.9mmH_2O$. The drops of both the caval and cerebrospinal fluid pressures were definite and marked on opening the shunt flow through the anastomosis, but these postoperative pressures retained still higher ones above their levels measured at thoracotomy. The pathological examinations of the brain and the spinal cord were also performed in six animals. Characteristic changes uniformly seen in all area and in all animals were the findings of capillary congestion and perivascular edema. On the other hand, ischemic nerve cell changes were rather evident, revealing their degrees and extents being related to the prolongation of the time of caval occlusion which has followed by the sustained high pressures in both the superior vena and the cerebrospinal fluid. The experiment suggests the safety of this surgical procedure with minimal, if any, permanent damage as long as the occlusion of the caval blood flow is not prolonged beyond the expected.