쇄골하정맥을 이용한 J 형의 전극도자를 가진 심방 Pacemaker 이식치험 2예

이두연,홍승록,이웅구,Lee, Du-Yeon,Hong, Seung-Rok,Lee, Ung-Gu 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.2

The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.

신생아의 양측성기흉을 동반한 긴장성 종격동 기종

이두연 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.3

Pneumomediastium in a newborn baby is a rare condition and is usually manifested by respiratory and circulatory distress syndrome. We recently have experienced a newborn baby of severe tension pneumomediastinum associated with bilateral pneumothorax. The patient in this report was a day old female and the mother of the baby a lot of difficulties during her delivery and the aid of vaccuum was necessary. This patient was received closed thoracotomy and followed by explothoracotomy and excision of tension multiple air bubbles. The post-op. course is not uneventful.

기관지 확장증의 임상적 고찰

이두연,조범구,홍승록,Lee, Doo Yun,Cho, Bum Koo,Hong, Sung Nok 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

During the past fifteen and one half years, a total of 64 cases of bronchiectasis were treated by pulmonary resection. The diagnosis of bronchiectasis was made relatively easily and accurately with bronchography. The average age of onset in the present series was 21 years old. Preoperative bronchograms were taken in all cases and revealed involvement of the left lower lobe in 14 cases, the right lower lobe in one case, the right upper lobe in 3 cases, the left lower lobe anal lingular segment in 9 cases, and multilobar involvement in cases. Bronchographically 18 tubular and II saccular and 2 cystic and 2 saccular and tubular forms were noted. Various types of pulmonary resection were performed on 59 cases. Complication developed in two cases. One showed pulmonary vein bleeding and was treated completely by reoperation; the other case developed empyema.

흉총창에 의한 심방파열 치험 2례

이두연,곽상룡,Lee, Doo-Yun,Kwack, Sang-Ryong 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.1

We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

고양이의 절제된 폐단면에 histoacryl 의 폐쇄효과에 대한 실험적 연구

이두연,오중환,방정현,Lee, Du-Yeon,O, Jung-Hwan,Bang, Jeong-Hyeon 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.2

Segmental resection or wedge resection of the lung and direct cutting across of bronchi frequently results in postoperative airleaks or bronchopleural fistula in some cases. Many methods have been devised to handle air leak problems by oversuturing the raw edges, the application of pleural onlay flaps, the use of cautery or tissue adhesives, but these still has not solved the problem of air leaking from raw surfaces of the lung with only partial successful we have tried the use of histoacryl to closure the raw surface of the resected lung and compared it’s results with of the closure with chromic catgut sutures in cats from May 1989 to Jan. 1990 at the department of the thoracic and cardiovascular surgery, Yonsei University, College of Medicine. Ninety lobe of the lungs were used in this study and forty nine of which have been divided segmentally and closed with histoacryl on the raw surfaces. Forty one of which have been divided segmentally and closed with sutures using chromic catgut for control. There were air leakages in twelve cases among 49 cases with applying histoacryl and airleak were in two cases among 12 cases with reapply histoacryl, But there were air leak in two cases among 41 cases with sutures using chromic catgut and airleak were in one case among with resutures using chromic catgut.

생리적 심박동기 이식 치험 : VDD : 2예 VDD Type, a Report of 2 Cases

이두연,김원파,김혜승,이우형 梨花女子大學校 醫科大學 醫科學硏究所 1985 EMJ (Ewha medical journal) Vol.8 No.1

The implantation of pacemaker will be necessary in not only complete heart block after cardiac operation, but also sick sinus syndrome and a variable con-duction disturbancs. We had had so many experiences of single chamger pacemaker(VOO, VVI etc) implantation in patients with complete heart block. But single chamber ventricul-ar pacemaker had some problems because only ventricular pacemaker could not use normal sinus rhythm. Recently, we have tried to use the ventricular pacing system to a dual chamger pacing system in the patient with heart block. So many papers pointed that the decrease in cardiac out put of 15 to 25% with VVI pacing as compared with the normal sinus rhythm. We have experienced one 10 years old boy who had a sin-gle atrium had developed complete heart block after patch repair of atrial septal defect, and another 49 years old male patient who was suffered from frequent syn-cope with bradycardia. The first boy was taken VDD dual chamber pacemaker implantation through left subclavian vein puncture method on 14 days after open heart surgery because he had normal regular P-wave. And the second male patient was taken DDD typed dual chamger pacemaker im-plantation through left subclavian vein puncture and the DDD typed pacemaker was transformed to VDD pacemaker, also because he had normal regular P wave,too. Their postoperative couse was in uneventful and were discharged without complication. Their conduction have been in good to now.

Examination of nicotine content and enantiomeric purity of liquid electronic cigarettes in distribution

이두연,김아림,오준,윤영욱,조윤제,박춘화 한국분석과학회 2023 학술대회논문집 Vol.2023 No.5

외인성 식도 손상의 치료

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

Between May 1979 and April 1989, 213 patients with esophageal injuries visited the Department of the Thoracic and cardiovascular surgery Department, Yonsei University College of Medicine. There were 159 non perforated esophageal injuries accompanied by hematemesis, and 54 perforated esophageal injuries. The causes of non perforated esophageal injuries were Mallory-Weise Syndrome [%], corrosive esophagitis [54], esophageal carcinoma [4], foreign bodies [2], sclerotherapy due to esophageal varices [3]. The causes of perforated esophageal injuries were esophageal anastomosis[13], malignancies[17], esophagoscopy or bougienage[5], chest trauma[5], foreign bodies[5], paraesophageal surgery[3], others[6] In esophageal perforation due to foreign bodies, esophagoscopy or bougienage, there were 6 cervical esophageal perforations and 9 thoracic esophageal perforations. There were no mortalities in the treatment of the cervical esophageal perforations and 5 deaths resulted in the treatment of 9 thoracic esophageal perforations. And four of six patients with thoracic esophageal perforations died in the initiation of treatment over 24 hours, after trauma. There were another 12 deaths in the patients with chest trauma, malignancies or chronic inflammation except esophageal injuries due to foreign bodies or instruments during the hospital stay or less than 30 days after esophageal injuries. One patient with esophageal carcinoma died due to bleeding and respiratory failure after irradiation. Another patient with esophago gastrostomy due to esophageal carcinoma died of sepsis due to EG site leakage. One patient with a mastectomy due to breast cancer followed by irradiation died of sepsis due to an esophagopleural fistula. Two patients with Mallory-Weiss syndrome died; of hemorrhagic shock in one and of respiratory failure due to massive transfusion in the other. One patient with TEF died of respiratory failure and another died of pneumonia and respiratory failure. One patient with esophageal perforation due to blunt chest trauma died of brain damage accompanied with chest trauma.

늑간신경에 발생한 신경초종 1예

이두연,계기식,송계용,Lee, Du-Yeon,Gye, Gi-Sik,Song, Gye-Yong 대한흉부심장혈관외과학회 1978 Journal of Chest Surgery (J Chest Surg) Vol.11 No.3

Recently, we experienced a case of rare neurilemmoma originated from intercostal nerve [9th] in the right chest wall in a 25 year old male officer. The tumor was incidentally found in the routine chest X ray, where the round well circumscribed mass tumor the ninth rib with notching and sclerotic margin, suggesting slowly growing benign benign of chest wall was revealed and the tumor mass was easily extirpated in the exploratory thoracotomy, with uneventful recovery. Grossly, the tumor was firm, partly soft and well circumscribed, measuring 4.5X3.0X 3.0 cm with yellowish smooth outer surface, attached with intercostal nerve trunk. Cut surface exhibits partly grayish white and largely hemorrhagic areas. Microscopically, the characteristic palisading arrangement of schwann cells and Verocay bodies are seen but dominant features are cystic degeneration and hemorrhage with organization and fibrosis. The sheath of intercostal nerve and capsule of neurilemmoma were con joined. There is no evidence of malignancy. The tumor was confirmed as neurilemmoma of intercostal nerve, Antony type B.

실과 교육 본질을 통해서 본 교사의 실과 수업만족

이두연,이건남 한국실과교육연구학회 2017 학술발표대회 Vol.2017 No.05