• Journal of Chest Surgery
• /
• 제28권11호
• /
• pp.1025-1031
• /
• 1995

Thirty patients who underwent esophageal resections due to esophageal carcinoma and benign strictures, and esophagovisceral anastomoses were performed by hand suture in 11 patients[Group I and by using the end to end anastomosis[EEA stapler in 19 patients[Group II . Anastomoses were performed in the thoracic cavity in 24 patients[Right 19, Left 5 and in the cervical area in 6 patients. There was one operative mortality[3.3% in a cancer patient who underwent Ivor-Lewis operation using EEA stapler. She expired on POD 38 days due to renal failure and sepsis. There were two anastomotic leakage in the sutured group and no anastomotic leakage in the stapled group. Late anastomotic strictures occurred in 10 patients[52.6% in the stapled group compared to 2 patients[18.1% in the sutured group. Most of the patients with late anastomotic strictures responded to one or two trials of TTS dilations. Using EEA stapler in performing esophagovisceral anastomosis is a safe method with acceptable range of complication rate, and total admission period after the operation for group I was 30.3 days compared to 25.4 days in group II although it had no clinical significance. The follow up was possible in 23 patients; 5 patients in group I died within mean 12.6 months and 9 patients in group II within mean 14.2 months.

• 미생물학회지
• /
• 제9권2호
• /
• pp.69-73
• /
• 1971

On June in 1970 the authors discovered a pathogenecity, cytoplasmic polyhedrosis virus, of the Smithia virus in the larvae of Liparis dispay L. appeared on quercus forest in Chung-Neung district and had carried out a experiment to detect the pathogenecity of Smithia virus through the inoculation of it into the larvase, such as Liparis dispay L. Hyphantrea cunea DRURY, and Dendrolinus spectabilis BUTLER. The results obtained were as follows ; 1) Death rate of L.dispay and D.spectabilis treated by 10$^{6}$ /ml cytoplasmic polyhedrosis virus of Smithis virus were 88.0% and 85.5% respectively, when the larvaes of these insects are big enough. But there were none of pathogenecity in case of Hyphantrea cunea DRURY. 20 Dead larvae caused by the injection of Smithia virus had begum to find out about on 10 days after inoculation. Miximum death rate of L. didpay and D. spectabilis appeared on 20-25days nad on 25-30days, respectively, after the incoulation. 3) In the cytoplasm of Mid-gut cylindrical cells of both of these insects, polyhedrosis, such s hexagonal (0.5-2.0-6.0 micron) were found out and in these insects, polyhedrosis, such as hexaginal (0.5-2.0-6.0 mivton) were found out and in case of D.spectabilis were a few polyhedrosis, such as tetragonal, trianglar polyhedrosis. 4) Diluted concentration of `0$^{6}$ /ml cytoplasmic polyhedrosis virus of Smithia virus were spread out in the field conditions. The corrected mortality was confirmed as about 87.8%.

• Neonatal Medicine
• /
• 제18권2호
• /
• pp.337-344
• /
• 2011

목적: 신생아 시기에 수술적 치료를 한 위장관계 질환과 저체중 출생아에서 발생 빈도가 높은 위장관계 질환에 대한 이해를 높이고자 한다. 방법: 2008년 1월부터 2010년 12월까지 부산대학교병원과 부산대학교 어린이병원 신생아실에 입원한 환아 중 위장관계 질환으로 진단되고 외과적 치료를 받은 125명과 괴사성 장염과 서혜부 탈장으로 진단받은 환아 40명을 대상으로 원인 질환 및 빈도, 출생력, 성별, 동반 기형과 혈청학적 결과를 살펴보았다. 결과: 괴사성 장염과 서혜부 탈장을 제외한 총 125명 환아 중에서 항문 직장 기형이 가장 흔하였고, 남성이 우세하였다. 24명(19.2%)에서 타기형이 동반되었고 수신증, 선천성 심장 기형이 많았으며, 항문 직장 기형에서는 43.9%에서 동반 기형이 있었다. 출생체중을 보면 괴사성 장염의 경우 76.0%가 1,500 g 미만으로 대부분을 차지하였다. 술 후 완전 장관 영양까지의 기간은 괴사성 장염이 평균 30.8일로 가장 길었다. 술 후 합병증은 담즙정체증, 패혈증과 유착 등이 있었다. 괴사성 장염을 제외한 위장관계 질환으로 수술적 치료를 받았던 환자들은 1.6%의 사망률을 보였으며 수술적 치료를 받은 괴사성 장염의 사망률은 18.8%였다. 괴사성 장염의 수술군에서 보존적 치료군보다 직접 빌리루빈이 의미있게 더 높았다. 결론: 수술적 치료를 받은 위장관 질환의 생존율은 높고 수술적 치료의 성과도 우수하였다. 괴사성 장염 환아 중 수술군에서 직접 빌리루빈이 유의하게 더 높았다.

• Journal of Chest Surgery
• /
• 제17권2호
• /
• pp.212-222
• /
• 1984

A total of and consecutive 291 patients underwent isolated mitral valve replacement using the Ionescu-Shiley bovine pericardial xenograft valve during the 5-year period between October 1978 and June 1983. Thirty-two patients were the children under 15 years of age. There were 15 deaths within 30 days after surgery [operative mortality, 5.2%]. All early survivors except 6 children were placed on the long-term oral anticoagulation longer than postoperative 3 months. A total follow-up period extended for 398.2 patient-years, and 12 patients died [late mortality, 4.1%, or 3.0%/patient- year]. Ten patients experienced the thromboembolic complication [2.51%/patient-year], occurring in 8 patients within the first 3 postoperative months, and 4 died. Three patients had the late prosthetic valve endocarditis [0.75%/patient-year] and 2 died. The incidence of overall valve failure according to the criteria was 3.01%/patient-year, or 12 patients, and 2 had replacement of the failed bioprostheses [primary tissue failure, 0.5%/patient-year]. The long-term survival rate was 87.8%\ulcorner2.6% at 5 years postoperatively, and 84% of the late survivors were in NYHA Class I at the end of the follow- up. The probability remaining free from thromboembolism and overall valve failure was 89.8%\ulcorner6.3% and 81.2%\ulcorner.8% at 5 years respectively. These clinical results confirm the safety of mitral valve replacement. The only remaining clinical problem is the structural and functional durability of the bovine pericardial xenograft valve, and its use in young patients may be stopped in preference to the mechanical prosthetic valves.

• Journal of Chest Surgery
• /
• 제17권4호
• /
• pp.678-686
• /
• 1984

Between Jan. 1978, and Dec. 1983, a total and consecutive 117 patients have undergone cardiac valve replacement using various artificial tissue valve. Out of 117 patients, single valve surgery was 78 consisted of MVR 74, AVR 3 and AVR & supracoronary ascending aorta replacement 1. Multiple valve surgery was 39 cases consisted of MVR+TAP 20, MVR+AVR 13 and so on. Early death with 30 days after operation was 12 cases [early mortality 10.3%] and causes of death were cardiac origin 5, technical problem 4, and others 3. The 105 early survivors were followed-up for a total of 190.5 years over a period of 2 to 64 months [Mean\ulcornerD:21.9\ulcorner4.9 months]. During follow-up, 7 cases died [late mortality:6.7%]. The rate of thromboembolism was 2.1% episodes per patient-year and bleeding due to anticoagulant was 3.1% episodes per patient-year and valve failure was 1.6% episodes per patient-year. Actuarial analysis of late results indicated an expected survival rate at 5 years of 84.6% for patients with single valve surgery and 82.1% for patient with multiple valve surgery and overall was 83.8%. Symptomatically, 86.7% of patients were in NYHA class I or II at the end of follow-up.

• Journal of Chest Surgery
• /
• 제26권5호
• /
• pp.365-372
• /
• 1993

We analyzed the patients who were admitted to Surgical Intensive Care Unit[SICU] of Kyungpook National University Hospital from January 1987 through December 1991. The results were as followings: The total number of patients for 5 years was 2446 and 1553[63.5%] were male,893[36.5%] were female. The average age was 34.1 years old and the greatest age group was the 1-9 age group.The number of the patients in the Department of Thoracic and Cardiovascular Surgery, which was the highest among all departments,was 1608 [65.7%].Congenital Heart disease was the most common among all diseases.The patients who had undergone any kinds of operations were 89.9% of all patients.The averge stay in SICU was 5.2 days.The overall mortality rate was 12.1% ,which included hopelessly discharged patients and the highest mortality rate occurred in the patients over 80 years old.The highest cause of death was cardiac problem[30.4%]. The next was sepsis.The proportion of patients who had received a mechanical ventilatory support was 35.7% and 52% of those patients belonged to the department of thoracic and cardiovascular surgery.

• 한국어병학회지
• /
• 제16권1호
• /
• pp.23-30
• /
• 2003

On September in 1998, a microsporidian infection was recognized in ayu, Plecoglossus altivelis, farmed on Kyongnam province of South Korea. Cumulative mortality was around 10% in 10 days. Infected fish which were piping for air near the surface of the water or in the asphyxic, lethargic condition revealed darkening of body and abdominal distention. Numerous whitish nodules up to 3mm in size were observed throughout most of body organs and tissues including gill, operculum, peritoneal wall and organs. Xenomas were also histologically confirmed in multiple internal organs with the evidences suggesting circulatory disturbance. Based on the morphology of spore and xenoma, and the distribution of xenomas in organs and tissues, this disease was diagnosed to be a microsporidiosis caused by Glugea plecoglossi. The mortality might be deeply related to the local circulatory disturbance by xemonas rather than the mechano-chemical effect of xenomas on adjacent tissues.

• Journal of Chest Surgery
• /
• 제26권1호
• /
• pp.18-23
• /
• 1993

Improved clinical performance was expected from the introduction of the low-profile model of the Ionescu-Shiley pericardial valve. The long-term clinical results were assessed on the consecutive 47 patients who underwent MVR + AVR with this valve between 1984 and 1988. Three patients died within 30 days of surgery[operative mortality, 6.4%], and 44 early survivors were followed up for a total of 203.8 patient-years [Mean + SD, 4.63 + 1.47 years]. One died during the follow-up with a linearized late mortality of 0.491%/patient~year[pt-yr]. None experienced thromboembolism. Bleeding and endocardiris were seen in each single patient with the incidences of complication of 0.491%/pt-yr respectively. The linearized rate of primary tissue failure [PTF] was 0.491%/pt-yr. The actuarial survival and rate of freedom from PTF were 97.6 _+ 2.4% and 92.6 +7.1% at 7 years of follow-up.These results are favorably comparable with the ones seen in the patients of MVR + AVR with the standard profile lonescu-Shiley valve in all respects except the higher mean age of the low-profile group. Although the clinical performance was compatible with other major reports, the durability of the valve remains to be proved with the prolonged follow-up.

• Journal of Chest Surgery
• /
• 제14권3호
• /
• pp.247-253
• /
• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• Journal of Trauma and Injury
• /
• 제36권3호
• /
• pp.253-257
• /
• 2023

A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.