동맥관 개존증에 합병한 심내막염에 의한 폐동맥 파열 치험 1예

조순걸,곽영태,김범식,노태훈,조규석,박주철,유세영 慶熙大學校 醫科大學 1984 慶熙 醫大 論文集 Vol.9 No.1

종격동경 검사의 임상적 의의

조순걸 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.4

The mediastinoscopy was a well known useful diagnostic tool for detection of mediastinal lymph nodes invasion by bronchogenic carcinoma, and also useful means for histologic diagnosis of metastatic carcinoma and certain mediastinal tumors. 31 cases of mediastinoscopies were reviewed which were experienced at Kyung Hee University Hospital from July, 1979 to June, 1985. We experienced 20 cervical mediastinoscopies, 10 left anterior mediastinotomy, and 1 both procedures. Of the 31 cases, 22 cases were used for preoperative staging of bronchogenic carcinoma, 7 cases for mediastinal tumor diagnosis, and 2 cases for histologic diagnosis of metastatic carcinoma. In 22 mediastinoscopies which were used for preoperative staging, 10 cases were revealed positive mediastinal nodes, and could avoid meaningless thoracotomy. All 12 mediastinoscopy negative patients were received thoracotomy, and 10 of them were resectable. The resectability in bronchogenic carcinoma was 83%, on the contrary, the other series at premediastinoscopic era revealed only 65% resectability. Other mediastinal lesions such as tuberculous granuloma [4], sarcoidosis [2], malignant thymoma [1], and metastatic carcinoma [2] were also diagnosed successfully. Mediastinoscopy is very useful tool for determination of treating method of bronchogenic carcinoma, and for diagnosis of certain mediastinal tumors which, otherwise, need a thoracotomy for confirmatory diagnosis.

종격동 종양 및 낭종 50례에 대한 임상적 고찰

조순걸 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.4

We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.

동맥관개존증에 합병한 심내막염에 의한 폐동맥파열 실험 1례

조순걸 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.4

Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

중엽 증후군(10예 보고)

조순걸 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.1

Ten cases of the right middle lobe syndromes were experienced. Nine out of ten were treated surgically, six-right middle lobectomy, one-right middle and lower lobectomy, one-right middle lobectomy and decortication, one-incidental right pneumonectomy. Pathologic diagnosis were tuberculosis in five, bronchiectasis in two, organizing pneumonia in one, and foreign body granuloma in one. There were three postoperative complications, postoperative empyema-1, pleural effusion-1, pneu-monia-1. The surgical candidates for middle lobe syndromes were; 1.Suspicious malignancy 2.Fixed bronchiectasis 3.Bronchostenosis 4.Intractability to medical treatment or recurrent atelectasis and obstructive pneumonia.

Effect of Phenobarbital on the Activities of Na^+/K^+ - ATPase in Rat Lung Tissue

Jo, Soon-Gul,Yoon, Kyung-Sik,Baik, Haing-Woon,Baik, Hyung-Hwan,Cho, Yong-Ho 慶熙大學校 1995 論文集 Vol.24 No.-

흰쥐 폐조직을 농도차 분별원심침전법으로 전균질분획, 상청분획, 침전분획으로 분리하여 각 분획내에 함유되어 있는 Na^+/K^+ -ATPase 활성을 측정하고, 흰쥐 폐조직내에 존재하는 이 효소의 세포내 국재소를 정하고, 특징적인 성상을 관찰하였다. 흰쥐 폐조직내에 존재하는 Na^+/K^+ -ATPase 의 총 활성은 전균질분획을 100% (약 261.6μㅡmoles/gr fraction)로 했을 때에 상청분획은 약 88% (약 230.4 μmoles)로, 침전분획은 약 12% (약 31.2 μmoles)로 각각 나타났으며, 이 효소의 활성을 37℃에서 1시간 동안 단백질 ㎎당 생성된 무기인량으로 비활성을 표시했을 때, 전균질분획에서는 약 0.10μmoles, 상청분획에서는 약 0.48μmoles으로 각각 나타났다. Na^+/K^+ -ATPase 활성에 미치는 ATP의 효과는 그 농도가 0.015mM일 때까지는 급격한 증가 형태로 각 분획에서 나타났고, 특히 상청분획에서 그 증가 정도가 심하였으나, 그 이상의 농도에서는 증가 정도가 둔화된 형태로 나타났다. Na^+/K^+ -ATPase 활성에 미치는 sodium 이온의 효과는 그 농도가 10mM일 때까지는 급격한 증가 형태로 각 분획에서 나타났고, 특히 상청분획에서 그 증가 정도가 심하였으나, 그 이상의 농도에서는 증가 정도가 둔화된 형태로 나타났다. Potassium 이온의 효과는 그 농도가 1.0mM일 때까지는 급격한 증가 형태로 각 분획에서 나타났고, sodium 이온의 경우와 마찬가지로 특히 상청분획에서 그 증가 정도가 심하였으나, 그 이상의 농도에서는 증가 정도가 둔화된 형태로 나타났다. Magnesium 이온의 효과는 그 농도가 0.5mM일 때까지는 급격한 증가 형태로 각 분획에서 나타났고, 특히 상청분획에서 그 증가 정도가 심하였으나, 그 이상의 농도에서는 증가 정도가 둔화된 형태로 나타났다. Phenobarbital은 그 농도가 약 0.1mM일 때 상청분획에서 효소활성을 가장 억제시키는 것으로 나타났다. 이상과 같은 실험결과로 보면, 흰쥐 폐조직의 전균질액내에 함유되어 있는 Na^+/K^+ -ATPase 활성은 주로 상청분획에 분포되어 있으며, 또한 비활성도 상청분획에서 가장 높게 나타났다. Sodium 이온, potassium 이온, magnesium 이온, ATP 등 기질은 각 분획에서 효소활성을 증가시키는 것으로 나타났고 특히 상청분획에서 증가시키는 정도가 가장 높게 나타났다. 또한, phenobarbital은 Na^+/K^+ -ATPase 의 활성을 억제시키는 것으로 나타났으나 효소와의 반응기전에 대한 연구는 계속되어야 할 것이다.

흉부자상에 의한 심실중격결손 및 승모판 부전증 치험 1예

김범식,조순걸,곽영태,조규석,박주철,유세영 慶熙大學校 1985 論文集 Vol.14 No.-

A 34-year-old man was stabbed with knife in the left fourth intercostal space. He was admitted to Kyung Hee University Hospital Emergency room with Cardiac tamponade state. Through a left anterior thoracotomy, a tense hemopercardium was released. A 2㎝ wound of right ventricle was sutured with 3-0 prolein. Seven month after the injury he was readmitted for cardiac catheterization. Cardiac catheterization confirmed the presence of an interventricular septal defect in the membranous septum with left ventricle to right ventricle shunt. A laceration of the septal leflet of mitral valve was also demonstrated. The pulmonary blood flow as 1.22 times the systemic flow. A longitudinal incision was made on the right atrium on the cardiopulmonary bypass. An 1×0.5㎝ interventricular septal defect was found in the membranous septum. In order to achieve and adequate repair interventricular spetal defect and mitral insufficency. The ventricular septal defect was repaired 3-0 prolein plegeted suture with interrupted. Artifical atrial septal defect was made and the septal leflet defect(1.5㎝) was reattached with 3-0 prolein plegeted suture interrupted. The partient had and uneventful post operative recovery and was discharged the Hospital on the 24day post operative day.

원저 : 기관지성 낭종의 임상적 고찰 ( Original Article : Bronchogenic Cyst - Report of 48 Cases - )

노태훈(Tae Hoon Rho),공현우(Hyun Woo Kong),김범식(Bum Shik Kim),조순걸(Soon Gul Jo),진재권(Jae Kwon Chin),조규석(Kyu Seok Cho),박주철(Joo Chul Park),유세영(Seh Young Yoo) 경희대학교 경희의료원 1985 慶熙醫學 Vol.1 No.1