• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.523-526
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• 2005

Purpose : Hypoalbuminemia is a rare cause of pleural effusion. The relationship between the severity of hypoalbuminemia and the clinical course of pleural effusion is unclear. The aim of this study was to evaluate the change of clinical course according to the severity of hypoalbuminemia due to pleural effusion in children. Methods : A total of 96 patients admitted to Pusan National University Hospital with pleural effusion from August 1998 to August 2004 were studied retrospectively. The 79 patients who had only infectious causes were evaluated according to their albumin levels. They were divided into the two groups : group 1 had serum albumin levels of ${\leq}2.5g/dL$; group 2 : >2.5 g/dL. The clinical courses of each group were compared. Results : The nature of pleural effusion was transudates in seven cases and exudates in 89 cases. The most commom causes of transudates were renal failure(four cases) and the most common causes of exudates were parapneumonic effusion(58 cases). There was no statistical significance in mean ages, BUN, creatinine, potassium, bilirubin and WBC in each group. Four patient in group 1 and 26 patients in group 2 improved after medication of antibiotics or anti-tuberculosis agents only. Fourteen patients in group 1 and 26 patients in group 2 improved after thoracostomy with use of antibiotics. Eight patients in group 1 and one patient in group 2 had ventilator care with use of antibiotics therapy. Conclusion : Children who were diagnosed as pleural effusion with low serum albumin levels on admission had poorer prognoses than those with normal levels. We conclude that lower serum albumin level on admission is an important prognosis factor in a patient with pleural effusion.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1165-1171
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• 1998

Background: All currently available mechanical and bioprosthetic valves are associated with various types of deterioration leading to dysfunction and/or valvular complications. Reoperation on prosthetic heart valves is increasingly under consideration for both clinical and prophylactic indications. This review was conducted to determine the factors affecting the risk of reoperation for prosthetic valve replacement. Material and method: From January 1985 to July 1996, 124 patients underwent reoperation on prosthetic heart valves, and 3 patients had a second valve reoperation. The causes of reoperation were prosthetic valve failure(96 cases, 77.4%), prosthetic valve thrombosis(16 cases, 12.9%), prosthetic valve endocarditis(7 cases, 5.6%) and paravalvular leak(5 cases, 4.1%). This article is based on the analysis of the experience with particular emphasis on the preoperative risks affecting the outcome of the reoperation. Result: Overall hospital mortality rate was 8.9%(11/124). Low cardiac output was the most common cause of death(70.6%). Left ventricular systolic dimension(p=0.001), New York Heart Association functional class IV(p=0.003) and serum creatinine level(p=0.007) were the independent risk factors, but age, sex and cardiothoracic ratio did not have any influence on the operative mortality. Follow-up period was ranged from 3 to 141 months (mean, 50.6 months). A late mortality rate was 1.8%. Conclusion: The surgical risk of reoperation on heart valve prostheses in the advanced NYHA class patients is higher, therefore reoperation is recommended before the hemodynamic impairment become severe.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1102-1110
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• 1996

Between Oct. 1985 and July 1995, 230 patients underwent mitral valve replacement. There were 77 men and 153 women whose mean age was 35.7 years, range 9 to 62 The concomitant operations were 40 aortic valve replacements(17.4%), 25 tricuspid annuloplasties(10.4%), 8 aortic valve replacements & tricuspid annuloplasties(3.5%), 2 tricuspid valve replacements(0.9%) and others, We used 139 mechanical (76 51. Jude medical, 33 CarboMedics, 30 Sorin) and 91 tissue 386 Carpentier-Edwards, 5 lonescu-Shiley) valves. The early postoperative complications occurred in 28 cases. There were 8 low cardiac output syndrome, 5 pleural effusion, 3 significant arrhythmia, 2 cardiac rupture and others. There were 6 early hospital deaths (2.6%) due to low cardiac output syndrome(2), arrhythmia(2) and ventricul r rupture(2). The cuAmulative notal follow-up period was 764. 4 patient-years with a mean of 4).9 months. The long term follow-up information was available for 212 patients(94.6%). There were 21 cases of valve-related complications. Prosthetic valve failure(10), anti-coagulation related bleeding (5), prosthetic valve endocarditis (4), and thromboembolism (2) occurred at rates of 1.3, 0.7, 0.5, and 0.3%Ipt-yr respectively. Late death occurred In 5 cases (0.7%/pt-yr) associated with prosthetic valve endocarditis (2), heart failure (2) and anti-coagulation related bleeding (1). There was no difference in the rate of freedom from prosthetic valve failure between the mechanical and tissue valve group at 6 years (100%), but there was significant difference at 9 years between the tissue (34.4%) and mechanical valve (100%) group (p=0.032). Actuarial survival rates were 98. 8% in tissue valve. 9).7% in mechanical valve group and 96.6% in total patients at 9 years.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.686-692
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• 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
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• v.30 no.7
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• pp.693-700
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• 1997

To assess the effectiveness of subxipoid pericardial drainage for the treatment of pericardial effusion, we reviewed 80 cases of subxiphoid pericardial drainage between January 1986 and December 1995. There were 39 males and 41 females with ages ranging from 20 to 80 years. The diagnosis of pericardial effusion was made by echocardiography. The procedure was carried out under general anesthesia in 50(62.5%) and under local anesthesia in 30 patients(37.5%). Among the 33 p tients with malignant pericardial effusion, cytology was positive .in 14 of 31(45%), and pericardial biopsy showed malignancy in 7 of 29 patients(24%). Among the 27 patients with tuberculous pericardial effusion, the diagnosis was confirmed by histology of pericardial biopsy in 12 patient or bacteriologic culture in 1 patient. The operative mortality was 17.5% (14180 patients) and all the mortality occurred in the malignant group. There were no operation-related mortality Sixty six patients were followed from 9 days to 5 years; mean follow-up was 452 days. Recurrent pericardial effusions, necessitating further surgical intervention, occurred in 6 (7.5%) patients. Constrictive pericarditis developed later in 4 patients(5%) and two of them had undergone complete pericardiectomy. In summary, subxiphoid pericardial drainage allowed safe and efficient drainage of pericardial effusions with sampling for cytology and pericardial biopsy, and had an acceptable morbidity and mortality.

• Journal of Acupuncture Research
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• v.25 no.1
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• pp.139-154
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• 2008

목적 : 홍화(紅花)는 활혈거어(活血祛瘀), 해독지통(解毒止痛)의 효능이 있어 관절염, 동맥경화(動脈硬化), 종양(腫瘍), 월경부조(月經不調), 뇌혈전(腦血栓)에 사용되어 왔다. 이에 홍화약침액(紅花藥鍼液)의 분자생물학적 효능 분석을 하고자 Lipopolysaccharide(LPS)로 염증을 유발한 RAW 264.7 cell의 유전자(遺傳子) 발현(發顯)에 미치는 영향을 Microarray를 통하여 관찰하였다. 방법 : RAW cell을 배양하고 홍화약침액(紅花藥鍼液)의 세포 독성을 확인한 후 (1) LPS, (2) 홍화약침액(紅花藥鍼液), (3) 홍화약침액(紅花藥鍼液)과 LPS를 처치했을 때의 유전자 발현양상을 microarray를 이용하여 관찰하였다. 대조군에 비해 2배 이상 발현의 차이가 있는 경우를 유의한 것으로 보았다. 결과 : 8,170개의 유전자 중 (1) LPS를 처치하였을 경우 35개의 유전자에서 발현이 상승되었고, (2) 홍화약침액(紅花藥鍼液)을 처치하였을 경우 11개의 유전자에서 발현이 상승되고 53개의 유전자에서 발현이 억제되었으며, (3) 홍화약침액(紅花藥鍼液)과 LPS를 동시에 처치하였을 경우에는 47개의 유전자에서 발현이 상승되었고 11개의 유전자에서 발현이 억제되었다. LPS 자극으로 발현이 상승되었지만 홍화약침액(紅花藥鍼液)을 처치할 때 발현이 억제되는 유전자는 SUMO1/sentrin specific protease 7(SENP7), Serine(or cysteine) proteinase inhibitor, clade B(ovalbumin), member 7(SERPINB7), M-phase phosphoprotein, mpp8(HSMPP8), Glycogenin 2(GYG2), InaD-like(Drosophila)(INADL), Copine III(CPNE3), Loss of heterozygosity, 11, chromosomal region 2, gene A(LOH11CR2A), Chromosome 9 open reading frame 33(SHC3), NADH dehydrogenase(ubiquinone) 1 beta subcomplex, 2, 8kDa(NDUFB2)로 9개가 있었다. 요약 : 홍화약침액(紅花藥鍼液)이 LPS로 염증을 유발시킨 RAW 264.7 cell의 유전자 발현에 미치는 영향을 Microarray를 통해 분석하였다. 홍화약침액(紅花藥鍼液)이 LPS로 발현을 항진시킨 35개의 유전자 중 9개를 효과적으로 억제하는 것을 확인하여 염증 치료 기전을 시사하는 유용한 자료를 얻을 수 있었으며 홍화약침액(紅花藥鍼液)이 발현을 항진시킨 유전자들을 통해 혈관생성과 종양억제 등 보다 넓은 범위에 대한 연구가 가능할 것으로 사료된다.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.146-153
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• 2004

As the experience of coronary artery bypass grafting (CABG) has been accumulated, the number of reoperation after CABG is increasing. We analyzed our clinical experience of redo-CABG. Material and Method: Fourteen patients who underwent redo-CABG between Jan. 1994 and Dec. 2002 were included in this study. The mean period from the first operation to reoperation was 66$\pm$56 (3∼157) months, and the average ages were 62.8$\pm$8.7 (51∼78) years. The survivors were followed up 39$\pm$29 (4∼101) months postoperatively. Indications of reoperation were stenosis or occlusion of previous grafts in 11 patients, progression of native coronary artery disease in one patient, and both etiologies in two patients. Result: There were two in-hospital mortalities (14.3%) resulting from low cardiac output syndrome, Postoperative morbidities were perioperative myocardiac infarction in 2 patients (14.3%), mediastinitis in one patient (7.2%), duodenal perforation in one patient, ischemic necrosis of the lower extremity in one patient, gastric perforation after mesenteric infarct in one patient, delayed brain infarct in one patient, and intraoperative splenic rupture in one patient. There was one late mortality at six months postoperatively during the follow up. There was no angina recurrence during the follow up. Conclusion: Although redo CABG demonstrated relatively high operative mortalities and morbidities, postoperative status and clinical outcome of the survivors were favorable.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.552-559
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• 2000

Background; The aim of this study is to evaluate our clinical experience with the Carbomedics heart valve prosthesis. Material and Method; Between Aug. 1988 and Dec. 1998, 294 Carbomidics valves were implanted in 235 patients(mitral; 143, mitral and aortic; 59, aortic; 33) The mean age at operation is 40.0$\pm$12.3 years(range 7 to 68 years); 63.8% (150patients) were woman. Follow up was 97.4% complete and mean follow up time was 5.7years with a total of 1209.2 patient-years. Result; The hospital mortality was 8.9%(mitral; was 95.2$\pm$1.6%(mitral ; 94.9$\pm$2.1%, mitral and aortic 95.0$\pm$3.7%, aortic 96.2$\pm$3.8%). Actual freedom rates from complications(linearized rates in parentheses) were fllowings; thromboembolism 96.2$\pm$1.5%(0.59%pt-yr), valve thrombosis 96.7$\pm$1.4%(0.5%/pt/yr), anticoagulant related hemorrhage 98.3$\pm$1.0%(0.25%/pt-yr), perivalvular leak 99.0$\pm$1.4%(0.5%/pt-yr), endocarditis 98.7$\pm$1.0%(0.25%/pt-yr), perivalvular leak 99.0$\pm$0.7%(0.17%pt-yr), endocarditis 98.7$\pm$1.0%(0.17%$\pm$pt-yr) and overall valve-related complications 88.9$\pm$2.5%(1.68%/pt-yr). Conclusion; The clinical performance of the Carbomedics valve was quite satisfactory with a low incidence of valve related mortality and morbidity.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.147-152
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• 2003

Purpose : The purpose of this study was to evaluate the arthroscopic findings of the transplanted human allogenic meniscus including MRI changes at follow up. Materials and Methods : From Oct. 1999 to Jun. 2002, nine patients underwent arthroscopic evaluation at follow-up. We used nonirradiated cryopreserved meniscus allograft for 6 cases and fresh-frozen for 3 cases. We used bone-plug method for medial meniscus and bone-bridge method for lateral meniscus to fix the transplanted meniscus. The average follow-up time was 13 months. We evaluated the result by lysholm score, MRI and second-look arthroscopic finding. Results : The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were well incorporated with surrounding capsular tissue. But one case showed wear on the post horn and the other case which was operated at other local clinic showed tear of the anterior hem due to non-anatomic placement of bone bridge. There was improvement of average Lysholm score form 64 to 87. Conclusion : Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment and early clinical results are satisfactory. But further studies are necessary to assess whether meniscal transplantation can prevent progressive degenerative changes.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.144-148
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• 2002

The present study was done to determine the efficacy and safety of varicose vein removal using a minimally invasive, powered vein-extracting device with cutaneous transillumination and tumescent anesthesia techniques and then compared this to a retrospective group of conventional phlebectomy operations. There were 133 limbs in 104 patients(72 women, 32 men) treated with the use of the vein extractor aided by transcutaneous illumination. The hydrodissection was performed with Trivex™ Irrigated illuminator(Smith & Nephe $w^{ R}$) system using normal saline after the 2~3mm sized skin incision. Varicose clusters were extracted by the use of TriveTM esector(Smith & Nephe $w^{ R}$) system under transillumination. After the varisoce vein extraction, the operation area was compressed with surgical pad for bleeding control. The complication rate was 3.84% The mean number of incisions was 3.24 and mean operative time per limb was 65.9 minutes. The mean hospitalization was 1.86 days. The varicose vein extraction using transilluminated powered phlebectomy(TIPP) is a safe, efficacious and cosmetically satisfactory method. The procedure decreases the operating time and the number of incisions required to remove varicose clusters. Further evaluation and long term follow up will be necessary to determine the recurrence rate and long termcomplications.to determine the recurrence rate and long termcomplications.