• Journal of Chest Surgery
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• v.42 no.1
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• pp.22-27
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• 2009

Background: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. Material and Method: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was $75.7{\pm}46.1$ months. Result: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). Conclusion: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.

• Tuberculosis and Respiratory Diseases
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• v.62 no.5
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• pp.437-440
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• 2007

Tracheostomy is one of the oldest surgical procedures in medical history. The indications for a tracheostomy include the relief of an upper airway obstruction, long-term mechanical ventilation, and decreased airway resistance to help wean the patient from mechanical ventilator support. Unfortunately, tracheostomy is also associated with a number of problems including, bleeding, infection, pneumothorax, and tracheal stenosis. A pneumothorax is an uncommon complication of a tracheostomy, and can result from direct injury to the pleura or positive pressure ventilation through a dislocation of the tracheostomy tube. We report an uncommon case of a tracheostomy-induced bilateral tension pneumothorax with a review of the literature.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.610-614
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• 1998

The first heart-lung transplantation in Korea was successfully performed. The recipient was a 11 year old girl with pulmonary atresia with intact ventricular septum. She had been catheterized at the ages of 4 months, 3 years, 7 years and 10 years, which revealed that neither Fontan nor biventricular repair was feasible. The donor was a traffic accident victim, a 9 year-old boy with the same blood type. The donor was pronounced dead according to the guidelines of the Korean Medical Association's Brain Death Committee. The operation was performed on April 20, 1997. The native heart-lung block was explanted segmentally and donor one was placed above the phrenic nerve using the Arizona technique. After the tracheal anastomosis with single continuous 4-0 prolene, both vena cavae were anastomosed, followed by aortic anastomosis. The graft ischemic time was 145 minutes. The postoperative course was complicated by fever and tracheal stenosis at the anastomosis site. The fever was controlled by anti-tuberculous medications and the tracheal stenosis was relieved by stent(Palmaz 8 mm, 30 mm in length) placement on POD #71. The patient is doing well and is very active in her 7th postoperative month.

• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.832-836
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• 2009

Plastic bronchitis is a rare disorder characterized by the formation of extensive, obstructing endobronchial casts. It is associated with asthma and complex cardiac defects such as those requiring the Fontan procedure. The treatment of plastic bronchitis comprises conventional therapy involving spontaneous expectoration and bronchoscopic removal and specific therapy with several new drugs. Herein, we describe the cases of 2 patients diagnosed with plastic bronchitis accompanied with a different underlying disease, which were treated with inhaled corticosteroid and low-dose oral clarithromycin.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1222-1225
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• 1998

Aortic valve replacement in young patients has its problems. Biologic prosthetic valves degenerate and need replacement. Metalic prosthetic valves are more durable, however, anticoagulation which has its inherent problems is inevitable. The use of Ross procedure in young patients is gaining wider acceptance. The need of foreign pulmonary valve in right ventricular outflow tract(RVOT) will require reoperation due to RVOT obstruction, later. To overcome this problem, we reimplanted the native aortic valve in the pulmonary position in 21 year old female patient operated on utilizing the Ross procedure for aortic insufficiency. We experienced that the diseased aortic valve worked well in the pulmoanry position because of low pulmonary artery pressure and resistance.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.504-509
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• 1999

Background: Heart transplantation is considerated for a selected certain group of complicated congenital heart disease in neonates because corrective surgery is very difficult and has high mortality. Precise planning of transplantation is necessary to adequately fit the donor heart to the recipient. Material and Method: We have performed 4 neonatal pig heart transplantations to test the technical feasibility. Experiment 1: The transplantation was performed using the same technique as the adult heart transplantation. Experiment 2: The transplantation for hypoplastic left heart syndrome was simulated as we reconstructed the whole aortic arch with donor aorta. Experiment 3: The heart transplantation was done with radical pulmonary artery reconstruction. Experiment 4: The experiment was performed for a long term survival. Result: Preoperative planning was very important for adequate fitting. All animals could be weaned from cardiopulmonary bypass, however, two animals died due to bleeding at pulmonary artery and left atrium. Conclusion: We concluded that the neonatal heart transplantation can be applied in some complicated Further using animal model is mandatory.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.711-715
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• 2001

Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

• Journal of Korean Medical classics
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• v.18 no.2 s.29
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• pp.20-44
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• 2005

통과한의학화서양의학적원리연구심신적상호관계(通過韓醫學和西洋醫學的原理硏究心腎的相互關係), 득도료여하결론(得到了如下結論) 경연구심신지간재한의학상구유(經硏究心腎之間在韓醫學上具有): 심양여신음유'심신상교'적'수화기제'관계(心陽與腎陰有'心腎相交'的'水火旣濟'關係). 차외환유신양(명문화)여심양(심화)적상호의존관계(此外還有腎陽(命門火)與心陽(心火)的相互依存關係). 우유심장신여신장정적상호의존관계이지유신정충족시(又有心藏神與腎藏精的相互依存關係而只有腎精充足時), 재가이사심주신지적공능유지정상(才可以使心主神志的功能維持正常). 경연구심신지간재서양의학상구유(經硏究心腎之間在西洋醫學上具有): 제일(第一), 심장여신장재해부학상밀절연계(心臟與腎臟在解剖學上密切聯係), 즉종심장좌심실분지출신동맥(卽從心臟左心室分枝出腎動脈), 진이형성신소구등신장적혈관구화모세혈관강(進而形成腎小球等腎臟的血管球和毛細血管綱). 제이(第二), 심장향신장공응혈액(心臟向腎臟供應血液), 신장시인체중접수혈공최다적장기(腎臟是人體中接受血供最多的臟器). 제삼(第三), 심장통과심납소(ANP)적분비(的分泌), 증가신혈류양급신소체여과율(增加腎血流量及腎小體濾過率). 제사(第四), 신장통과신소(腎臟通過腎素)(renin)적분비조절혈압(的分泌調節血壓). 제오(第五), 신공능부전대심장구성부면영향(腎功能不全對心臟構成負面影響). 제육(第六), 심장여신장지간종서양의학적각도고려(心臟與腎臟之間從西洋醫學的角度考慮), 야존재착상생화상극관계(也存在着相生和相克關係). 경연구심신적상호관계재수행중적작용(經硏究心腎的相互關係在修行中的作用), 득출여하결론(得出如下結論): 제일(第一), 수행영인안정심지(修行令人安定心志), 사심화하강(使心火下降). 제이(第二), 수행시적호흡조절조폐금생신수(修行時的呼吸調節助肺金生腎水), 저시소유적수행법도재중시호흡조절적근본이유(這是所有的修行法都在重視呼吸調節的根本理由). 제삼(第三), 수행시발생수승화강(修行時發生水昇火降). 저실제상시의뢰심화중적일음효여신수중적일양효적발동내완성(這實際上是依賴心火中的一陰爻與腎水中的一陽爻的發動來完成). 제사(第四), 통과수행(通過修行), 가이달도보정적목적(可以達到保精的目的), 유차보장생명적지보(由此保藏生命的至寶). 제오(第五), 통과수행(通過修行), 가이달도연정화기(可以達到煉精化氣), 약능주도연정화기(若能做到煉精化氣), 가사인체불누설정액(可使人體不漏泄精液), 반이화기이증강인체기능(反而化氣以增强人體機能), 시보정적유효수단(是保精的有效手段). 수행적관건시'남자수성불누정(修行的關鍵是'男子修成不漏精), 여자수성온불누경(女子修成不漏經)'.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.137-140
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• 2002

Aortic regurgitation in the pediatrics who had previous cardiac surgery is increased with their improved longterm survival rate and their complexity of heart disease. So the need of aortic valve surgery in pediatrics is also on the increase. A 10-year old boy was admitted for progressive cyanosis and dyspnea on exertion(DOE). The patient had been underwent lateral tunnel Fontan operation before. Echocardiography and cardiac catheterization study revealed hepatic vein drained to pulmonary atrium via intrahepatic collaterals, moderate atrioventricular regurgitation, and severe aortic regurgitation due to aortic root dilation. We report a case who had aortic root reconstruction, valvuloplasty of the atrioventricular valve, and hepatic vein ligation successfully Cyanosis and DOE was dramatically improved after the operation

• Journal of Chest Surgery
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• v.37 no.11
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• pp.929-932
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• 2004

The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.