• Journal of Chest Surgery
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• v.38 no.4 s.249
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• pp.291-300
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• 2005

One-stage repair of aortic arch anomalies and intracardiac defects through median sternotomy has been recently adopted by many institutions since it is known to be safer than the staged repair. The early and midterm results of the one-stage repair of aortic arch anomalies and intracardiac defects were retrospectively evaluated. Material and Method: 45 patients who underwent one-stage repair of aortic arch anomalies and intracardiac defects performed by one surgeon from January 1996 to July 2003 were included in this retrospective study. The median age of repair was 16 days (range, 3 days$\~$23.7 months) and the mean weight was $3.62\;\pm\;1.30 kg$. Thirty one $(68.9\%)$ had coarctation and 14 $(31.1\%)$ had interrupted aortic arch. Associated intracardiac anomalies were VSD in 31 patients (VSD group), TGA or Taussig-Bing anomaly in 10 (TGA group), and others in 4 (ASD in 1, aortopulmonary window 1, truncus arteriosus 1, aortic and mitral stenoses 1, miscellaneous group). The arch obstruction was repaired with end-to-side anastomosis in 23 patients and end-to-end anastomosis in 22. Result: Overall postoperative hospital mortality was $22.2\%\;(10/45);\;16.1\%$ (5/31) in VSD group, $40\%$ (4/10) in TGA group, and$25\%$ (1/4) in miscellaneous group. There was no mortality in VSD group since 1998, and the mortality in TGA group has remarkably reduced since technical modification for coronary transfer was adopted $(75\%\;vs\;16.7\%)$. There was no postoperative seizure or other neurological complications. Postoperative aortic restenosis occurred in 5 patients $(5/35,\;14.3\%)$. Two patients underwent balloon aortoplasty with successful results. There was no reoperation. There was one late death caused by pneumonia 5 months after the operation. Two-year actuarial survival rate including operative death was $72.9\%$. Conclusion: The operative mortality of one-stage repair has been reduced with time and aortic restenosis rate was also acceptable. We concluded that this procedure is a reproducible procedure for aortic arch anomalies associated with intracardiac defects.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.438-441
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• 1999

Background: Minimally invasive cardiac surgery has emerged as a new approach to the conventional median sternotomy. The suggested advantages of the minimally invasive technique includes improved cosmesis, simplicity of opening and closing the chest, less postoperative pain, less risk of infection and bleeding, early rehabilitation, and reduced length of hospital stay. Material and Method: Between March 1997 and December 1997, we performed 36 cases of minimally invasive cardiac surgery via three different approaches ; right paramedian, transverse sternotomy and mini-sternotomy with upper sternal split. Result: There was no operative mortality. Postoperative complications were atrial fibrillation in 4 patients, bleeding that required reoperation in 1 patient, and delayed wound closure in 1 patient who underwent 3rd redo operation. Average length of skin incision was 9.1${\pm}$0.9 cm. Average duration of stay in the intensive care unit was 48${\pm}$29 hours and the patients were discharged 10${\pm}$7 days after the operation. Conclusion: In spite of the difficulties in defibrillation, deairing, and cardiac decompensation, minimally invasive approaches will be applied increasingly because of the suggested advantages.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.325-330
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• 1986

Eosinophilic granuloma is one of the histiocytosis X. It may occur in any bone and tissues, but the one originated from the sternum was rarely reported. Recently, we experienced an eosinophilic granuloma at the manubrium sterni, associated with diabetes insipidus, which was surgically resected. Although intranasal spray of DDAVP has been used for the control of diabetes insipidus, the bony lesion was remitted. With the brief review of the literatures, we report the case.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.217-221
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• 1991

Bronchiectasis is bilateral in approximately 30% of patients. Although the presence of bilateral bronchiectasis was frequently considered a contraindication to surgical resection due to excessive loss of functional pulmonary parenchyma, it is a correct view that the involved broncho-pulmonary segments are functionless and risks to the as yet uninvolved segments and should be removed if the patient`s pulmonary function is tolerable. We report a case of multisegmental bilateral bronchiectasis treated by bilateral simultaneous pulmonary resection through a median sternotomy. Five bronchiectatic segments were resected, which were right middle lobe, anterobasal segment of the right lower lobe, and lingula of the left upper lobe.

• Journal of Chest Surgery
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• v.15 no.3
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• pp.308-310
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• 1982

During the closure of the sternum, following the mitral valve replacement for mitral stenoinsufficiency, hemodynamic instability with cardiac tamponade was developed. After transfusion of massive diuretics and albumin for a few times, reclosure of the sternum was attempted with development of hemodynamic instability. And so we decided delayed sternal closure. After 72 hours of mitral valve replacement, delayed sternal closure was done with success, and so we report this case with literatures.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.820-824
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• 1990

A very early and effective technique of sternal closure by plastic plates was successfully applied to a 7-months-old infant of tetralogy of Fallot in whom the standard closure of sternum was not possible due to massive generalized edema after cardiopulmonary bypass for total correction. This technique provides not only solid but also permanent closure of the sternum so that any early reoperation for closure of sternum and its accompanying risk of infection in many other known methods can be avoided.

• Proceedings of the KSLP Conference
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• 1996.11a
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• pp.91-91
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• 1996

현재 시판되고 있는 전기 인공후두는 손으로 인공후두를 경부에 장착하고, 음의 intensity와 pitch를 변하기 위하여 스위치를 손가락으로 조절해야만 하는데, 실제 회화 중에 잘 조절한다는 것은 거의 불가능하므로, 음질과 명료도가 나쁘며, 발성을 의도했을 때 자유롭게 발성하는 것도 어렵다. 또한 회화 중에는 한손은 항상 전기 인공후두를 위해 사용해야 한다. 이러한 단점을 개선하기 위해, 본 연구에서는 흉골설골근 근전위에 의해 제어되는 인공후두를 제작하여 그 성능을 평가하였다. (중략)

• Journal of Chest Surgery
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• v.32 no.10
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• pp.966-969
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• 1999

Congenital defects of the sternum are rare development anomalies. They result form the failure of the lateral sternal bars to fuse. This malformation may be associated with other ventral midline fusion defects and ectopia cordis. A complete sternal cleft is the rarest form and less than 10 cases have been reported in the medical literature. Here were report a 3-day-old boy with complete sternal cleft without other malformations, who underwent primary surgical repair. Surgical correction of complete sternal cleft should be performed in neonatal period whether the infant if symptomatic or not because it is usually simple, able to achieve good result and primary repair is usually feasible at this period.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.34-34
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• 1991

식도게실은 식도 근육층의 결손 부위로 점막층이 감입됨으로써 발생하는 국한성 낭성 구조물로서 선천성 또는 후천성으로 발생할 수있다. 저자들은 1990넌 4월 17일 식사시 흉골 상부의 불쾌감을 주소로 중앙대학교 부속병원을 내원한 32세 여자 환자에서 식도 조영 촬영상 식도 우후방부, 윤상인두협부 하방 3㎝ 부위에서, 흔히 볼 수 있는 Zenker's diverticulum이 아닌 식도게실을 발견하여 식도게실제거술 및 근절개술 시행으로 특이한 합병증 없이 치유된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.708-709
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• 1994

Tuberculosis infection of sternum is extremely rare. The most common cause of sternal osteomyelitis is infection of a median sternotomy incision, employed for most cardiac operation. If a wound infection of this regeon becomes apparent, the wound should be opened wide to allow adequate drainage. Frequent irrigation and debridement are necessary to avoid extension of the infection into the bone. We have experienced a 16 years old female who has been operated upon due to ASD, was infected with tuberculosis in sternum. Our team have treated her for tuberculous osteomyelitis on sternum with curettage and drainage.