활로 4징증의 외과적 완전교성 수술에 관한 임상적 고찰

임승평,외2인 대한순환기학회 1979 Korean Circulation Journal Vol.9 No.2

휴벽에 발생한 원발성 연골육종

임승평,서경필,Im, Seung-pyeong,Suh, Kyung-Pill 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.2

A 36 years old male patient underwent en bloc excision of the primary chondrosarcoma arising from 8th, 9th and 10th ribs of the chest wall. The tumor was 11.5 x 7.5 x 6.5 cm in size and was 320 gram in weight. After en bloc excision of the tumor, the defect of the chest wall was reconstructed with pedicle muscle flap and using compression dressing for 2 weeks, there happened no respiratory problem. And so we made a case report and review of literature.

Ebstein 심기형의 개심술 4례 (삼첨판막 대치이식술 및 우심실 Plication)

임승평,양기민,이영균,Im, Seung-Pyeong,Yang, Gi-Min,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.4

Ebstein`s anomaly had been amenable to reparative surgery since 1962. However, neither the role of surgery in Ebstein`s anomaly nor the surgical procedure of choice for its correction are clearly defined. Whether or not the atrialized right ventricle, which plays a major role in the functional abnormalities, should be obliterated in all cases remains unsolved. Four cases of Ebstein`s anomaly treated surgically at Seoul National University Hospital were reported. All had closure of the atrial septal defect, obliteration of the atrialized right ventricle by plication, and insertion of a tricuspid bioprosthesis and an epicardial ventricular pacemaker. One patient had a pulmonic valvotomy due to stenotic bicuspid pulmonic valve also. All but one had discharged with a good result.

전이성 폐암의 외과적 치료

임승평 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

From July 1987 to July 1993, four patients received pulmonary resection for pulmonary metastasis from carcinoma or sarcoma at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. There were 2 males and 2 females and their respective ages were 38, 68, 35 and 23 years. The primary tumors were Ewing's Sarcoma, Adenocarcinoma, Synovial Sarcoma and Adenoid Cystic Carcinoma and their sites were tibia(Lt), stomach, tibia(Rt) and submandibular salivary gland(Lt), respectively. The disease free intervals were 41, 31, 0 and 24 months, respectively. The operative procedures were 2 lobectomies, 1 segmentectomy and 1 wedge resection. The durations the of follow-up after operation for pulmonary metastasis were 18, 11, 21 and 15 months, respectively.

말초감각신경 자극이 동맥혈압변화에 미치는 영향에 관한 연구

임승평,김전,김종환,Lim, Seung-Pyung,Kim, Jun,Kim, Chong-Whan 대한흉부심장혈관외과학회 1987 Journal of Chest Surgery (J Chest Surg) Vol.20 No.3

The arterial blood pressure response elicited by stimulating the peripheral afferent fibers of different groups and origins was studied in cats. Experimental animals were anesthetized with a-chloralose [60mg/kg] and artificially ventilated with a respirator. The lumbosacral spinal cord was exposed through a laminectomy and L7 ventral root was isolated. The sural, medial gastrocnemius and common peroneal nerves were also exposed in the hindlimb. The arterial blood pressure was monitored continuously while the exposed peripheral nerves and L7 ventral root were being stimulated. Then, spinal lesions were made on the dorsolateral sulcus area, dorsolateral funiculus and other areas at the thoracolumbar junction. The arterial blood pressure responses were compared before and after making spinal lesions. The following results were obtained. 1. The mean arterial blood pressure was elevated from 103*7.3 to 129*8, 1 [mean*S.E.] mmHg [p<0.001] during stimulation of the sural nerve with C-strength [1000T], 20Hz. Stimulation with Ad-strength, 1Hz resulted in the depression of the arterial pressure by 8 mmHg [p<0.01]. 2. Stimulation of the medial gastrocnemius nerve with Ad-strength did not elicit any significant change in arterial blood pressure. Stimulation with C-strength, 20 Hz induced a pressor response from 102*6.2 to 117*6.4 mmHg [p<0.01] while that with C-strength, 1Hz induced a depressor response from 104*6.1 to 93*4.9 mmHg [p<0.001]. 3. A pressor response by 56 [from 107*7 5 to 163*9.4] mmHg [p<0.001] was induced during stimulation of the common peroneal nerve with C-strength, 20Hz stimuli. Stimulation with A4-strength, 1Hz depressed the arterial blood pressure from 111~9.3 to 94*7.8 mmHg [P<0.005]. The activation of the ventral root afferent fibers with C-strength, 20 Hz stimuli induced a pressor response by 22 mmHg [from 115*9.4 to 137*8.6 mmHg] [p<0.001]. 4. The pressor response elicited during stimulation of the sural nerve was abolished by making lesions on the dorsolateral sulcus area bilaterally. With the medial gastrocnemius nerve, the pressor response had not been abolished completely by the dorsolateral sulcus lesions. The pressor response disappeared completely with addition of the bilateral dorsolateral funiculus lesions. 5. The depressor response induced by stimulation of the sciatic nerve with Ad-strength, 1Hz was decreased by making lesions on the dorsolateral funiculus. 6. From the above results it is concluded that the difference in the blood pressure responses to the activation of the muscular afferent and the cutaneous afferent fibers is responsible for the groups of afferent fibers and the spinal ascending pathways.

動脈管開存症의 外科的 治療

林承平 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

A Clinical analysis was performed on 94 cases of patent ductus arteriosus treated surgically during the period of 10 years from Aug. 1977 to Aug. 1987. at the Department of Thoracic and Cardiovascular Surgery, Chungnarn National University Hospital. Among 94 cases, male was 37 and female was 67 and ages ranged 12 days to 27 years old with the average of 7 ^11/12 years. The major clinical symptoms on admission were frequent respiratory infection (64.9%), dyspnea on exertion (37.2%) and palpitation (14.9%). On auscultation, continuous machinery murmurs were detected in 80 cases (85.1%) and loud systolic murmurs were detected in 14 cases (14.9%). Preoperative electrocardiographic findings were as follows: LVH 46 (48.9%), RVH 9 (9.6%), BVH 13 (13.8%) and WNL 26 (27.7%). Radiographically, there were increased pulmonary vaseularity in 86 (91.5%) and cardiomegaly in 64 (68.1%). Cardiac catheterizations were performed in 70 cases and meam systolic pulmonary arterial pressure was 47.2±24.3 mmHg and mean Qp/Qs was 2.39±1.05. Methods of operation were multiple ligation in 76, division in 10 and trans-pulmonary arterial repair using cardiopulmonary bypass in 8. Complications were recannalization in 2, temporary hoarseness due to left recurrent laryngeal nerve paralysis in 3 and respiratory distress in 1 and overall mortality rate was 1% (1 case).

개심술 치험 10례 보고

임승평 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.1

This report is concerned to our experience of 10 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital during the period between May, 1982 and February, 1983. 1. Six cases were male and two cases were female. Age was varied from 21 years to 50 years and mean age was 34 years. 2. The cases included 2 Ventricular Septal Defects, 1 Atrial Septal Defect, I Tetralogy of Fallot and 6 acquired valvular heart diseases. 3. The surgical managements were 3 primary repairs for Ventricular Septal Defects and Atrial Septal Defect, I total correction for Tetralogy of Fallot and 6 mitral valve replacements with bovine xenograft by Ionescu-Shiley combining 3 Tricuspid annuloplasties [ De Vega method ] and 1 deauricularization of left atrial appendage for acquired valvular heart diseases. 4. The average cardiopulmonary bypass time was 37 minutes for acyanotic congenital heart diseases and 92 minutes for cyanotic heart disease and acquired valvular heart diseases. And the average aortic cross clamping time was 19 minutes for the former and 70 minutes for the latter. 5. Postoperatively, there were 1 hemolytic anemia, 1 congestive heart failure, 1 hemolytic jaundice and 1 thermal burn as complications, but there was no operative mortality. 6. All patients received valve replacement were recommended anticoagulation with Persantin and Aspirin.

개심술에 의한 승모판막교련절개술의 임상적 고찰

임승평 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

A clinical analysis was performed on 30 cases of mitral stenosis received open mitral commissurotomy during the period of 5 years from April 1983 to April 1988 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. Among 30 cases, male was 8 and female was 22 and ages ranged between 17.3 years and 53.2 years old with the average of 37.5 years. The major clinical symptoms on admssion were dyspnea on exertion, palpitation, hemoptysis and chest pain in order, with the average duration of 7.3 years. The preoperative electro cardio graphic findings were RVH(21 cases), LAE(17 cases) and atrial fibrillation (10 cases). The cardiac catherization were performed in 27 cases and mean systolic pulmonary arterial pressure was 56.52+26.43mmHg and mean pulmonary artery wedge pressure was 26.29±10.44 mmHg. Intraoperatively, there were 5 cases of left atrial thrombosis, but there was no postoperative complication. Overall, functional results were excellent after surgery, with 29 cases returning to New York Heart Association functional class I or Ⅱ initially.

비청색증 선천성 심장질환의 임상적 고찰 : 심실중격결손증 42예 분석 Analysis of 42 Cases of Ventricular Septal Defect

임승평 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

A clinical analysis was Performed on 42 cases of ventricular septal defect experienced at Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital daring 2.5 years period from April, 1983 to September, 1985. Of the 42 patients of ventricular septal defect, 29 patients were male and 13 patients were female and and ages ranged 1.4 years to 23 years old with the average age of 9.3 years. The chief complaints on admission were dyspnea on exertion (66.7%), frequent respiratory infection (59.5%%) and palpitation (16.7 %). Electrocardiographic findings were as follows: LVH 16(38.1%), BVH 12(28.9%) and RVH 4(9.5%). Cardiac catherizations were performed in 42 patients and mean Q_p/Q_s was 1.9 and mean systolic pulmonary artery pressure was 51.9 mmHg. 16 associated cardiac anomalies were found in 14 patients; Patent Foramen Ovale 5, Atrial Sectal Defect 3, Patent Ductus Arteriosus 3. Aortic Regurgitation 2, Mitral Regurgitation 1, Double Outlet Right Ventricle 1 and Left Superior Vena Cava 1. In anatomical classification by Kirklin, Type Ⅰ constituted 10 cases(23.8%), Type Ⅱ 30(71.4%) and Type Ⅲ 2(4.8%). Mean extracorporeal circulation time was 55.4min. and mean aortic cross clamping time was 36.7min. and varied by closing method and associated anomalies as in cases of primary closure closure, 37.5min. and 23.7min. and in cases of patch closure, 73.2min and 49. 8min., respectively. Postoperative complications were wound infecton 4, respiratory failure 3, residual shunt 3, epididymitis 1 and overall mortality rate was 4.8%(2 cases).

종격동 종양의 임상적 고찰

임승평 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

A clinical analysis was performed on 55 cases of primary mediastinal tumors proved histopathologically, either resection or biopsy, from August 1977 to November 1990, at the Department of Thoracic and Cardiovascular Surgery, Chung-nam National University Hospital. Among 55 cases, mlae was 24 and female was 31 and ages of patients were ranged between six months and 67 years old with average 31.1 years. The primary tumors included neurogenic tumors (41.8%), teratomas(21.8%), thymomas(14.5%), benign cysts(10.9%) and a miscellaneous group. The posterior mediastinum was the most commonly involved site of a primary mediastinal tumor (49.1%), followed by the anterosuperior mediastinum(40.0%) and the middle mediastinum(10.9%). The most frequent histopathologic types of the primary mediastinal tumor were teratoma and thymoma in the anterosuperior mediastinum, benign cyst and teratoma in the middle mediastinum and neurogenic tumor in the posterior mediastinum. Malignant neoplasms were present in 11 patients(20.0%). Symptoms were present in 63.5% of the patients and included chest pain or discomfort(23.6%), dyspnea(14.6%), cough(7.3%), neck mass, ferquent URI and generalized weakness. 30.1% of the lesions in symptomatic patients was malignant. 49 cases of the patients(89.1%) were treated with complete resection, two cases with partial resection and four cases were biopsied only. Among 11 patients with malignant lesions, five patients received postoperative chemotherapy, two patients received irradiation, two patients received chemotherapy and irradiation and two patients refused further postoperative adjuvant therapy. Postoperative complications were bleeding, Horner's syndrome, pleural effusion and sympathetic nerve injury in five patients and there have been no surgical mortality.