• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.213-221
• /
• 1990

We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.753-758
• /
• 1996

From January 1987 to December 1994, twenty five patients with cancer of the esophagus were t eated surgically at the department of Thoracic and Cardiovascular Surgery, Tae Jeon Eul ll General Hospital. Among them, male was 24 cases, female was 1 case, with age ranged from 40 to 74 years, mean age was 60.4 years. The most common symptoms were dysphagia 92.0%, general weakness 28.0%, subsiernal pain 16.0%, weight loss 16.0 oyo , The tumor locations were the upper third in 2, middle third in 17, lower third in 6. Surgical treatment was done with transthoracic esophagectomy and esophagogastrostomy 1~4 cases, transthoracic esophagectomy and esophagocologastrostomy 5 cases, Transthoracic esophagectomy and jeT junal interposition 2 cases, palliative feeding gastrostomy 4 cases. The postoperative complications included anstomotic leakage in 3 cases, empyema in 3 cases, wound in- fection in 2 cases, atelectasis in 2 cases, pleural effusion in 1 case, hoarseness in 1 case, pneumothorax in 1 case, necrosis of jejunal loop in 1 case, aspiration pneumonia in 1 case. The operative mortal ty were 3 cases (12.0 %) and causes of death were aspiration pneumonia 1 case. sepsis and respiratory failure in each 1 . The mean survival period was 9.75 months. Recurrence of cancer revealed in 3 cases.

• Clinical and Experimental Pediatrics
• /
• v.52 no.9
• /
• pp.1029-1034
• /
• 2009

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects children. There are few reports that describe the Epstein-Barr virus (EBV) as the possible infectious agent of KD. Here, we describe a case of KD in a 15-year-old boy complicated with giant coronary artery aneurysms, pericardial effusion, and splenic infarction. The clinical course of KD was refractory to intravenous gamma globulin and aspirin. Our patient also showed typical findings of concomitant EBV-associated infectious mononucleosis, such as hepatosplenomegaly and generalized lymphadenopathy, with EBV-positive atypical lymphoid hyperplasia. He improved dramatically after receiving intravenous methylprednisolone followed by oral prednisolone. Ultimately, the coronary artery aneurysms remained as the only sequelae. We report a rare case of adolescent KD with EBV-associated infectious mononucleosis and splenic infarction.

• Clinical and Experimental Pediatrics
• /
• v.49 no.1
• /
• pp.107-111
• /
• 2006

Crohn disease (CD) is rare, but the incidence of CD has been increasing over the past ten years. We found two cases of CD, associated with myelodysplastic syndrome (MDS), for the first time in children. In the first patient, MDS was diagnosed at three years of age and CD developed later at eight years of age. The patient presented with recurrent abdominal pain, diarrhea, bloody stools and failure to thrive. Colonoscopy revealed cobble stone like mucosa and mass like lesions with superficial ulceration and inflammatory exudates, observed from the cecum to ascending colon. Ileo-cecal biopsy samples showed ulcers with skipped areas and lymphoid infiltrations. The patient was started on treatment with mesalazine and deflazacort, and symptoms remitted. In the second patient, MDS was diagnosed at nine years of age and CD developed at 13 years of age. This patient has recurrent hematochezia, abdominal pain, vomiting and fever. Colonoscopy revealed a large, deep indurative ulceration on the cecal side of the ileo-cecal valve. Ileocecectomy was done, and histology revealed ulceration with transmural inflammation and lymphoid aggregates. Symptoms improved after ileocecectomy.

• The Korean Journal of Pharmacology
• /
• v.23 no.1
• /
• pp.51-56
• /
• 1987

Cyclobuxine D was extracted from Buxus microphylla var. koreana Nakai. The effects of cyclobuxine D on the biosynthesis of prostaglandins from arachidonic acid in guinea pig lung, prostaglandin production and leukocyte migration in carrageenin-induced inflammation was investigated. These effects of cyclobuxine D were compared with those of aspirin and dexamethasone. Cyclobuxine D does not inhibit significantly cyclooxygenase in guinea pig lung but reduces prostaglandin concentration and leukocyte migration in inflammatory exudates. These effects of cyclobuxine D differ from that of aspirin which inhibits biosynthesis of prostaglandin in vitro and has a relative small effect on leukocyte migration. Dexamethasone, which does not inhibit cyclooxygenase in vitro, has an effect similar to that of cyclobuxine D on leukocyte migration and prostaglandin production in inflammatory exudates.

• Journal of Chest Surgery
• /
• v.30 no.7
• /
• pp.686-692
• /
• 1997

This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07$\pm$ 1176 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median stemotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta andfor partial or total aortic arch were performed in 9 patients, descending aorta andfor t oracoabdominal aorta in 3 and total aorta in 1, Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta andfor aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67 $\pm$ 29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in .

• Journal of Chest Surgery
• /
• v.43 no.4
• /
• pp.437-440
• /
• 2010

Cardiac mesotheliomas are rare. It is difficult to diagnose them at an early stage because the symptoms are nonspecific. Here we report two cases that had been initially diagnosed as constrictive pericarditis but later were definitively diagnosed, after pericardiectomy, as mesothelioma. The two patients complained of dyspnea that lasted 4 months and 10 years. Chest CT showed mild pericardial effusion and thickened pericardium, which was found enveloping the heart without any lumps. Median sternotomy showed that the overall pericardium was thickened by more than 10 mm. Pericardiectomy (phrenic nerve to phrenic nerve) was performed and post-operative histology confirmed malignant mesothelioma. In one patient the disease recurred near the pericardium post-operatively at 7 months and the patient died at 11 months. The other patient received chemotherapy and was still alive at post-operative month 16. Pericardial mesothelioma is an extremely rare disease exhibiting clinical signs similar to those of constrictive pericarditis, and should be diagnosed at an early stage of onset.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.2
• /
• pp.272-278
• /
• 1999

The primary lymphoma in the lung is very rare. Moot of the primary pulmonary lymphomas, which represent 3-4 % of extra-nodal lymphomas, are low-grade B-cell lymphoma. The low-grade B-cell lymphomas progress slowly and the prognosis of these are more favorable than that of the nodal lymphomas. However, high-grade forms progress rapidly with more severe course. The diagnosis of primary pulmonary lymphomas generally relies on the histopathologic findings of lung specimens obtained by surgical excision of the lesions or open-lung biopsy. Recently, less aggressive biopsies(transbronchial, transthoracic) and/or immunocyto-chemical, immunochemical and gene rearrangement studies on materials obtained by bronchoalveolar lavage have been used occasionally. The treatment of the primary pulmonary lymphomas has not been precisely codified. Several clinical data suggest that limited surgery or non-aggressive chemotherapy can provide long-term survival in patients with such slowly developing neoplasm, and demonstrated the need for the development of noninvasive diagnootic methods. In this study, we report a case of high-grade B-cell lymphoma of the lung which was treated with combination chemotherapy.

• Pediatric Infection and Vaccine
• /
• v.15 no.2
• /
• pp.206-211
• /
• 2008

Streptococcus pneumoniae is a common cause of acute otitis media, sinusitis, pneumonia, and the invasive bacterial infections in children. Rarely, S. pneumoniae is an uncommon cause of hemolytic-uremic syndrome (HUS). We report a 33 month-old girl who presented with pneumonia, and subsequently developed HUS. Her pulmonary infection was complicated by necrotizing pneumonia and acute respiratory distress syndrome. Cultures from blood and pleural fluid grew S. pneumoniae, serotype 19A. She was treated with antibiotics, dialysis and mechanical ventilatory support. She was discharged with normal renal function after 2 months of management. She remained healthy without renal complications at the 5 year follow-up visit.

• 제어로봇시스템학회:학술대회논문집
• /
• 1986.10a
• /
• pp.607-612
• /
• 1986

최근 테니스의 저변인구가 크게 증가함에 따라 테니스 라켓의 제작기술도 상당한 수준에 이르렀고 설계제작의 자동화에 의해서 양질의 제품이 시판되고 있다. 그러나 라켓에 볼이 임팩트될때 생기는 진동으로 야기되는 테니스 엘보우 등, 해결해야 할 문제들이 아직도 남아 있다. 이와같이 테니스 라켓의 정적인 강도 뿐만아니라 동적인 특성도 중요한 관심의 대상이 되어감에 따라 볼 컨트롤을 용이하게 한다거나, 안정타점영역(Sweet Spot)의 확장과 그립부의 진동등에 의해서 발생하는 엘보우 현상을 방지하기 위해 여러가지 연구가 수행되어 왔다. 특히, 다차원 스펙트럼해석 및 모우드 해석법에의해 그립부에 미치는 진동원의 동정과 라켓의 동적거동에 대해서 연구되었고, 라켓의 재질변경과 그립부의 구조변경에 의한 안정타점영역에 영향을 미치는 모우드 파라미터(Modal Parameter)의 추정에 관한 연구도 수행되었다. 이러한 연구들은 결국 안정타점영역을 확장시키거나 테니스 엘보우를 방지하기 위한 것으로서 이러한 목적을 달성하기위해 테니스 라켓의 진동 모우드에 관계되는 파라미터들을 찾아서 그 모우드 파라미터의 변화에 따르느 진동 모우드의 거동에 대해서 연구할 필요가 있다. 본 논문에서는 실험적인 모우드 해석법을 실제 테니스 라켓에 적용하여 모우드 파라미터들을 구한 다음 그 파라미터의 변화에 따르는 안정타점영역의 변화를 컴퓨터 시뮬레이션을 통해서 예측하였다. 또한 안정타점영역을 넓히고 라켓의 동특성을 개선시킬 수 있는 모우드 파라미터를 찾아서 테니스 라켓의 설계, 제작 단계에 정보를 제공하는 CAD(Computer Aided Design)에 좋은 자료를 얻고자 한다. 있으나 파도에 의한 영향이 가장 크므로 본 논문에서는 파도에 의한 영향만을 고려하였다. 파도는 쌍동선에 외란으로 작용하며 측정할 수 없는 양이므로 PID, LQ 제어에서는 제어모델에 포함되지 않지만 LQG 제어에서는 제어모델에 포함된다. LQG 제어의 경우 제어모델에 파도를 백색잡음으로 가정하고 제어기를 구성한 것 (LQG1)과 2차의 쉐이핑필터(shaping filter)를 사용하여 구성한 것(LQG2)으로 나누었다.져 한다.) 식도 이물에 의한, 또는 식도경술에 의한 합병증이 초래한 경우는 식도점막열상 1례 (1.8 %), 식도 천공 1례 (1.8 %) 였으며, 기도이물에 의한, 또는 기관지경술에 의한 합병증이 초래한 경우는 무기폐 2례 (11.1 %), 폐렴 3례 (16.7 %)로 나타났다.5예에서 소실되었다. 5 ) 청각심리검사 (Psychoacoustic evaluation)에서 폴립은 술전에 Grade 1∼2의 사성이 있었던 11예중 술후 10예에서 Grade 0로 되었으며 Grade 1∼2의 사성이 있었던 3예의 결절에서도 모두 Grade 0로 정상화되었다.>치를 측정한 결과 투여전과 차이가 없었다. 7) 이상의 결과로 볼때 Cis-platinum 사용으로 인한 이중독증은 신장기능이 정상일때는 충분한 hydration으로써 예방이 가능하며 동시에 금기로 알려져왔던 감음성난청이 있는 두경부악성종양환자에서도 세심한 주의하에 적절히 사용한다면 좋은 결과를 얻을 수 있을 것으로 사려된다.은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다. 1) 이관폐쇄술후 18시간에 최초로 삼출액이 확인되었으며 그 이후는 전실험군에서 삼출성중이염이 유발되다. 2