• Journal of Chest Surgery
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• 제27권9호
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Chest Surgery
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• 제20권1호
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• pp.55-69
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• 1987

The result of valve failure with the lonescu-Shiley pericardial xenograft was presented with the review of current knowledge. This study reviewed 557 patients, who underwent total of 683 lonescu-Shiley pericardial valve replacement from 1979 to 1985 at Seoul National University Hospital. There were 357 patients who had mitral valve replacement, 73 with aortic valve and 127 with double valve replacement. There were 35 operative deaths. The survivors were followed at OPD. There were 32 patients who had prosthetic valve failure, whose ages ranged from 11 to 58 years [mean 27.8] and their postop interval was 56 ~ 22 months [range; 6-87] The causes of valve failure are prosthetic valve endocarditis in 14, primary disruption or calcification in 13, paravalvular leakage in 4, and others in 2 patients. Redo valve replacement was done in 12 patients after a mean interval of 50 * 20 months. [range; 6-79 months] Actuarial analysis of late results indicates actuarial freedom from endocarditis at 6 year is 87.9 ~ 6.8%, and actuarial freedom from primary disruption or calcification or paravalvular leakage at 5 year is 84.4 * 2.3%. In this series, however, valve failure due to thrombosis is not included.

• Journal of Chest Surgery
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• 제20권4호
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• pp.695-705
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• 1987

This report provides follow - up data on 37 patients, aged 7 days to 25 years [median: 6.5 months], who underwent repair of total anomalous pulmonary venous connection at Seoul national University Hospital between May, 1978 and June, 1987. The patients were 22 males and 17 females and the sex ratio was 1.6 to 1, showing a male predominance. Sixteen patients had supracardiac, 13 cardiac, 3 infracardiac and 5 had a mixed type. The duration of follow up was from 1 month to 60 months [median: 14 months] There were eight early and one late deaths, and the overall mortality was 24%. The deaths during 1 year of life were eight [89%] and only one death [11%] occurred above 1 year of age. The mortality of cardiac type was unusually high, accounting for 56 percent of the total death, which was probably due to the preoperative poor clinical condition such as pulmonary edema and congestive heart failure. The major cause of death was the perioperative myocardial failure, and the survival was closely related to the preoperative clinical status, age and moderately elevated pulmonary arterial pressure, the sign of the elevated pulmonary vascular resistance and pulmonary venous obstruction. Early diagnosis and early application of surgical intervention is essential to the improved postoperative survival

• Journal of Chest Surgery
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• 제20권4호
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• pp.730-744
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• 1987

From Nov. 1980 to Jun. 1987, 270 primary lung cancer patients were operated on at the department of Thoracic & Cardiovascular Surgery, Seoul National University Hospital. There Were 223 males & 47 females with 55.5 years of mean age. There were 151 [55.9%] squamous cell ca., 43 [18.8%] adenoca., 8 [3.5%] undiff. large cell, 9 [3.9%] undiff. small cell ca. & 18 [7.9%] mixed type, and also composed of 65 [28.3%] stage I, 31 [13.5%] stage II and 133 [58.1%] of stage III cases. They received 78 [34.1%] lobectomies, 62 [27.1%] pneumonectomies and 60 [26.2%] exploratory thoracotomies with 70% resectability rate. The five year actuarial survival rate of all patients was 37%. According to TNM stage, five year survival rate of the patients in stage I was 71%, those of stage II was 29% and of stage III 21%. According to histological cell type, five year actuarial survival rate of the squamous cell ca. was 35%, of adenoca. 49%, of undiff. large cell. 22%, 2 year survival rate of undiff. small cell was 31% and 3 year survival rate of mixed type was 47%. Hospital death was 2 case with a 1.3% early postop. mortality rate.

• Journal of Chest Surgery
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• 제43권4호
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• pp.441-446
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• 2010

이상적인 도관은 직경이 커야 하고, 조직 독성이 적으며 감염에 강하고 장기 성적도 좋아야 한다. 대복재정맥은 실제에서 많이 사용되고 있지만 만족할 만한 혈류를 위해서는 때때로 시간을 기다려야 할 필요가 있다. 저자들은 단시간 내 적절한 혈류확보를 위한 생체도관으로서 표재성 대퇴정맥을 사용한 2예를 보고한다.

• Journal of Chest Surgery
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• 제22권1호
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• pp.32-41
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• 1989

We scrutinized the 64 cases of TGA and Taussig-Bing anomaly who underwent Senning and Mustard operations from Jan. 1981 to May 1988. The ratio of male to female was 45; 19, and the age at operation varied from 2 months to 18 years [mean 18.9*32.9 months]. The in-hospital mortality was in 24 cases [37.5%] and the major causes were myocardial failure and congestive heart failure associated with arrhythmias. The risk factors for hospital mortality were complex TGA, prolonged bypass time and high postoperative CVP. In addition, mortality increased during the first year the procedure was used. Late mortality occurred in 6 cases and the major causes was congestive heart failure, and there was not any significant risk factor noted in late mortality. Early arrhythmia developed in 37.5%, all of which were transient and self limited and 7 cases of early mortality were related to the arrhythmias. Late arrhythmias developed in 8 cases, but 7 cases were transient. One case died with junctional tachycardia. Of significance the one case that died late by arrhythmia had a similar junctional tachycardia in the early postoperative period. The survival rate in all cases disregarding initial in-hospital mortality 1YSR 89.8% and 5YSR 84.3%, but because of short duration of follow up this is not significant. We concluded that early hospital mortality could be decreased by operating at an earlier age and by adjusting the appropriate operation method.

• Journal of Chest Surgery
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• 제26권7호
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• pp.521-525
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• 1993

Sixty-three patients who underwent open mitral commissurotomy at Sejong General Hospital during last 10 years from the August, 1983 to June, 1993 were reviewed There were fifty-one women and twelve men, and the mean age was 34.2 years. According to the NYHA classification, the distribution of patient preoperatively was as follows: class I, 5 patients ; class II, 26 patients ; class III, 30 patients ; class IV, 2 patients, and mean duration of symptome was 4.5 years. The mean mitral valvular area measured with echocardiogram preoperatively was 0.92cm2. All patients underwent open mitral commissurotomy and 41 patients required additional procedures for relief of subvalvular stenosis or other valvular disease. There were no operative death. 63 patients had three different types of mitral stenosis : type I, mobile cusps without subvalvular change [21 patients] ; typeII, thickened cusps with subvalvular change [34 patients] ; type III, rigid cusps with severe subvalvular change [8 patients]. The valvular calcification was seen in 11 patients [17%] and 15 patients [24%] had left atrial thrombus. The duration of follow-up was from 1 month to 168 months [mean, 39.6 months] and there were no late death. Six patients required reoperation and one patient had embolic episode. Conclusively,the open mitral commissurotomy represents a safe surgical precedure for treating mitral stenosis, allowing a complete removal of atrial thrombosis if present, and even when associated with subvalvular changes.

• Journal of Chest Surgery
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• 제26권1호
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• pp.24-31
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• 1993

The long term clinical results following valve replacement with Hancock and Carpentier-Edwards bioprostheses were compared between tow valve models and between tow groups totaling 249 patients who were discharged after valve replacement from 1976 to 1986. The two groups of patients were treated with nonrandomized fashion. Follow-up was 87% complete. Cummulative duration of follow-up was 1909 patient-years, with maximum follow-up duration of 15 years. The actuarial survival for 122 patients with Hancock valves was 95.2%[\ulcornerstandard deviation] and 84.4% after 5 and 10 years of follow-up, respectively. Comparable figures for 127 patients undergoing valve replacement with Carpentier-Edwards valves were 87.3% and 76.4%, respectively[p=NS]. The probability of freedom from structural valve deterioration after 5 and 10 years of follow-up was 97.2% and 60.6%, respectively, with Hancock valves and 97.2% and 55.7%, respectively, with Carpentier-Edwards valves[p=NS]. Considering all 249 patients, multivariate [Cox model] regression revealed that ejection fraction was only significant predictor of structural valve deterioration. The probability of freedom from thromboembolism after 5 and 10 years of follow-up was 91.3% and 86.4%, respectively, with Hancock valves and 94.2% and 82.5%, respectively, with Carpentier-Edwards valves[p=NS]. Hence more strict control of anticoagulation should be done on patients with left atrial factors. In summary, there were no significant differences in actuarial survival rate and major valve related complications between tow valve models. These results suggests that its use should be confined to older patients or patients with a contraindication of anticoagulation.

• Advances in pediatric surgery
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• 제14권2호
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• pp.125-133
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• 2008

To evaluate the long-term prognosis of biliary atresia after Kasai operation, a total of 14 patients (of the 41 patients operated upon from 1982 to 1997), who had been followed up for more than 10 years, were included in this retrospective study. Eleven out of 14 patients survived with their native livers, and their data analyzed for age at operation, clearing time of jaundice, histological outcome, postoperative complications, effectiveness after the application of an intussusception anti-reflex valve, and quality of life. Average age at surgery was 62.8 days. Serum bilirubin was normalized within three months in all patients. Six among the eleven long-term survivors had ascending cholangitis as one of the postoperative complications. The application of an intussusception anti-reflux valve did not show any statistical significance in long-term survival. Most of long-term survivors appeared to enjoy good quality of life. Kasai operation might not be the definitive treatment for biliary atresia; however, Kasai operation made it possible to achieve long-term survival for patients with biliary atresia when the patients were detected and treated as early as possible.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2004년도 춘계학술대회
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• pp.2129-2134
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• 2004

The present study has been conducted to develop a heat pump system using river water of temperature energy which not only belongs to unutilized energy but is a kind of good heat source due to maintain its temperature in a certain degree regardless of seasonal variation. The system did not meet the proposed performance after setup. In this paper, the system performance affected by refrigerant Oil, by pressure drop, or by other factors has been discussed. The followings were obtained : (1) Refrigerant Oil mixture rate was 2.5 in weight percentage, (2) Pressure drop through evaporator was 29.1kPa($3.1^{\circ}C$ in saturated tempearture) (3) Pressure drop from the end of evaporator to compressor inlet was 39.8kPa($4.0^{\circ}C$ in saturated tempearture). (4) The system performance can to be improved by modifying a part of pipe line to compressor, and reducing pressure drop through heat exchangers.