• Title/Summary/Keyword: Cardiothoracic surgery

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Surgical Treatment of Left Ventricular-Right Atrial Shunt (좌심실-우심방 단락의 외과적 치료)

  • 이응배;허동명
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.945-950
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    • 1996
  • Twelve patients with left ventricular-right atrial shunt (LV-RA shunt) underwent surgical correction be- tween April 1982 and March 1995. Seven patients were male and five patients were female. Age ranged from 3 to 26 years with mean age of 8.5 years. On the preoperative chest PA views, increased pulmonary vascularity was noted in 3 cases and enlargement of right atrium in 4 cases. The mean preoperative cardiothoracic ratio was 0.59. Echocardiographic studies were obtained in 9 patients and the preoperative echocardiographic diagnoses were LV-RA shunt in 2 cases, ventricular septal defect (VSD) in 6 casei, and atrial septal defect (ASD) in 1 case. The preoperative ngiographic diagnoses which were obtained in all patients were LV-RA shunt in 5 cases, VSD in 5 cases, ASD in 1 case, and VSD with ASD in 1 case. The descriptions of defect of LV-RA shunt according to intraoperative findings were supravalvular defect in 5 cases(42%), infravalvular defect in 4 cases (33%), and combined defect in 3 cases (25%). Associated anomalies of tricuspid valve in 4 cases of infravalvular defect were perforation (3 cases) and cleft (1 case). Primary closure of the septal defect was performed through the right atriotomy in all but one patient. There was no operative death. One patient underwent reoperation because of the residual interventricular shunt. All patients have been in good condition.

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Clinical Characteristics and Prognostic Factors of Lung Cancer in Korea: A Pilot Study of Data from the Korean Nationwide Lung Cancer Registry

  • Kim, Ho Cheol;Jung, Chi Young;Cho, Deog Gon;Jeon, Jae Hyun;Lee, Jeong Eun;Ahn, Jin Seok;Kim, Seung Joon;Kim, Yeongdae;Kim, Young-Chul;Kim, Jung-Eun;Lee, Boram;Won, Young-Joo;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.2
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    • pp.118-125
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    • 2019
  • Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

Pulmonary Valve Replacement with Tissue Valves After Pulmonary Outflow Tract Repair in Children (소아에서 폐동맥유출로 재건 후 시행한 조직판막을 이용한 폐동맥판 대치술)

  • Lee, Jeong-Ryul;Hwang, Ho-Young;Chang, Ji-Min;Lee, Cheul;Choi, Jae-Sung;Kim, Yong-Jin;Rho, Joon-Ryang;Bae, Eun-Jung
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.350-355
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    • 2002
  • Background: Most of pulmonary regurgitation with or without stenosis appears to be well tolerated early after the repair of pulmonary outflow tract. However, it may result in symptomatic right ventricular dilatation, dysfunction and arrhythmias over a long period of time. We studied the early outcome of pulmonary valve replacement with tissue valves for patients with the above clinical features. Material and Method: Sixteen consecutive patients who underwent pulmonary valve replacement from September 1999 to February 2002 were reviewed(9 males and 7 females). The initial diagnoses included tetralogy of Fallot(n=11), and other congenital heart anomalies with pulmonary outflow obstruction(n=5). Carpentier-Edwards PERIMOUNT Pericardial Bioprostheses and Hancock porcine valves were used. The posterior two thirds of the bioprosthetic rim was placed on the native pulmonary valve annulus and the anterior one third was covered with a bovine pericardial patch. Preoperative pulmonary regurgitation was greater than moderate degree in 13 patients. Three patients had severe pulmonary stenosis. Tricuspid regurgitation was present in 12 patients. Result: Follow-up was complete with a mean duration of 15.8 $\pm$ 8.5months. There was no operative mortality. Cardiothoracic ratio was decreased from 66.0 $\pm$ 6.5% to 57.6 $\pm$ 4.5%(n=16, p=0.001). All patients remained in NYHA class I at the most recent follow-up (n=16, p=0.016). Pulmonary regurgitation was mild or absent in all patients. Tricuspid regurgitation was less than trivial in all patients. Conclusion: In this study we demonstrated that early pulmonary valve replacement for the residual pulmonary regurgitation with or without right ventricular dysfunction was a reasonal option. This technique led to reduce the heart size, decrease pulmonary regurgitation and tricuspid regurgitation as well as to improve the patients'functional status. However, a long term outcome should be cautiously investigated.

Association between the CYP1A2 rs762551 Polymorphism and Bladder Cancer Susceptibility: a Meta-Analysis Based on Case-Control Studies

  • Zeng, Yong;Jiang, Hua-Yong;Wei, Li;Xu, Wei-Dong;Wang, Ya-Jie;Wang, Ya-Di;Liu, Chuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7249-7254
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    • 2015
  • Background: Previous studies evaluated associations between the CYP1A2 rs762551 polymorphism and bladder cancer risk. However, the results were inconsistent. We therefore performed a meta-analysis of the published case-control studies to assess in detail the association between CYP1A2 rs762551 polymorphism and bladder cancer risk. Materials and Methods: PubMed, Embase and Web of Science were searched to identify relevant studies and the pooled odds ratio (OR) and 95 % confidence interval (95%CI) were calculated. Results: A total of seven articles including 3,013 cases and 2,771 controls were finally included. Overall, a significant association was found between the CYP1A2 rs762551 polymorphism and bladder cancer susceptibility for CC vs AA (OR=0.82, 95% CI=0.69~0.99), but no significant associations were found for the other three models (AC vs AA: OR=0.91, 95% CI=0.81~1.02; the dominant model: OR=0.90, 95% CI=0.80~1.00; the recessive model: OR=0.84, 95% CI =0.72~1.00). In the subgroup analysis by ethnicity, we detected significant associations between the CYP1A2 rs762551 polymorphism and bladder cancer susceptibility for GA vs GG (OR = 0.78, 95% CI =0.64~0.96) and for the recessive model (OR=0.80, 95% CI=0.66~0.96) in Caucasians, but not for Asians. Conclusions: The results from the meta-analysis suggested that the CYP1A2 rs762551 polymorphism is a protective factor for bladder cancer, especially in Caucasians.

A Case of Spinal Cord Compression Caused by Rhabdomyosarcoma of the Mediastinum Associated with Type I Neurofibromatosis(NF Type I) - Case Report - (제 I 형 신경섬유종증에 병발하였던 종격동내 횡문근육종에 의한 척수압박 1례 - 증례보고 -)

  • Kim, Sei-Yoon;Whang, Kum;Hong, Soon-Ki;Pyen, Jhin-Soo;Hu, Chul;Kim, Hun-Joo;Han, Young-Pyo;Lee, Myoung-Sup;Lee, Chong-Kook;Cho, Mee-Yon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.642-646
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    • 2001
  • A 12-years-old female admitted to the hospital with the complaint of pain on the right upper chest area which persisted about 1 month prior to admission. $Caf{\acute{e}}$-au-lait spots of various size laying on a whole body and freckling on the axilla were found on physical examination. A huge mass was found on the plain chest X-ray and on chest MRI. The mass encroached thoracic spine, posterior rib, back muscles, and then into the neural canal and compressed thoracic spinal cord. On the 5th day of hospitalization, the patient complained tingling on the both legs and 2 days later, monoparesis on the right leg. Open thoracotomy and decompressive laminectomy was done to remove mass. Pathologic reports confirmed rhabdomyosarcoma, embryonal type.

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Noise in hospital rooms and sleep disturbance in hospitalized medical patients

  • Park, Marn Joon;Yoo, Jee Hee;Cho, Byung Wook;Kim, Ki Tae;Jeong, Woo-Chul;Ha, Mina
    • Environmental Analysis Health and Toxicology
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    • v.29
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    • pp.6.1-6.6
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    • 2014
  • Objectives Hospitalized patients are vulnerable to sleep disturbances because of environmental stresses including noise. While most previous studies on hospital noise and sleep have been performed for medical machines in intensive care units, there is a limited data for patients hospitalized in medical wardrooms. The purpose of present study was to measure noise level of medical wardrooms, identify patient-perceived sources of noise, and to examine the association between noise levels and sleep disturbances in hospitalized patients. Methods Noise dosimeters were used to measure noise level in 29 inpatient wardrooms at a university hospital. Sleep pattern and disturbance were assessed in 103 hospitalized patients, using the Pittsburgh Sleep Quality Index (PSQI) and Leeds Sleep Evaluation Questionnaire. Results The mean equivalent continuous noise level for 24 hours was 63.5 decibel A (dBA), which was far higher than 30 dBA recommended by the World Health Organization for hospital wardrooms. Other patients sharing a room were perceived as the most common source of noise by the patients, which was usually preventable. Of the patients in the study, 86% had bad sleep as assessed by the PSQI. The sleep disturbance was significantly correlated with increasing noise levels in a dose response manner. Conclusions Systemic organizational interventions are needed to keep wardrooms private and quiet to reduce sleep disturbance.

A Life-Threatening Case of Tubular Esophageal Duplication Complicated with Aneurysm of the Aorta (대동맥류를 초래한 식도 중복 1례)

  • Jung, Yeon Kyung;Lee, Gyeong Hoon;Chung, Hai Lee;Park, Ki Sung;Jung, Kyung-Jae;Cho, Chang Ho
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.655-659
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    • 2005
  • Esophageal duplication cysts are rare congenital lesions that occur as a result of a failure in the tubulation of the esophagus. They are most frequently single, tubular, or cystic. They may cause compressive symptoms or may be discovered incidentally on chest radiographs. They become symptomatic when complications develop. Symptoms often are related to the location of the duplication; esophageal lesions can create respiratory difficulties. The definitive diagnosis of esophageal duplication cysts requires the pathological evaluation of the cyst after surgical removal. We experienced a rare tubular esophageal duplication, in a 2-month old girl who presented with fever and grunting. This is the first reported case in which the sequence of events of ruptured tubular esophageal duplication with empyema, mediastinitis and aneurysm occured.

Screening of Differentially Expressed Genes among Various TNM Stages of Lung Adenocarcinoma by Genomewide Gene Expression Profile Analysis

  • Liu, Ming;Pan, Hong;Zhang, Feng;Zhang, Yong-Biao;Zhang, Yang;Xia, Han;Zhu, Jing;Fu, Wei-Ling;Zhang, Xiao-Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6281-6286
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    • 2013
  • Background: To further investigate the molecular basis of lung cancer development, we utilize a microarray to identify differentially expressed genes associated with various TNM stages of adenocarcinoma, a subtype with increasing incidence in recent years in China. Methods: A 35K oligo gene array, covering about 25,100 genes, was used to screen differentially expressed genes among 90 tumor samples of lung adenocarcinoma in various TNM stages. To verify the gene array data, three genes (Zimp7, GINS2 and NAG-1) were confirmed by real-time RT-PCR in a different set of samples from the gene array. Results: First, we obtained 640 differentially expressed genes in lung adenocarcinomas compared to the surrounding normal lung tissues. Then, from the 640 candidates we identified 10 differentially expressed genes among different TNM stages (Stage I, II and IIIA), of which Zimp7, GINS2 and NAG-1 genes were first reported to be present at a high level in lung adenocarcinoma. The results of qRT-PCR for the three genes were consistent with those from the gene array. Conclusions: We identified 10 candidate genes associated with different TNM stages in lung adenocarcinoma in the Chinese population, which should provide new insights into the molecular basis underlying the development of lung adenocarcinoma and may offer new targets for the diagnosis, therapy and prognosis prediction.

Downregulation of FoxM1 sensitizes nasopharyngeal carcinoma cells to cisplatin via inhibition of MRN-ATM-mediated DNA repair

  • Li, Dandan;Ye, Lin;Lei, Yue;Wan, Jie;Chen, Hongyan
    • BMB Reports
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    • v.52 no.3
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    • pp.208-213
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    • 2019
  • Chemoresistance is the primary obstacle in the treatment of locally advanced and metastatic nasopharyngeal carcinoma (NPC). Recent evidence suggests that the transcription factor forkhead box M1 (FoxM1) is involved in chemoresistance. Our group previously confirmed that FoxM1 is overexpressed in NPC. In this study, we investigated the role of FoxM1 in cisplatin resistance of the cell lines 5-8F and HONE-1 and explored its possible mechanism. Our results showed that FoxM1 and NBS1 were both overexpressed in NPC tissues based on data from the GSE cohort (GSE12452). Then, we measured FoxM1 levels in NPC cells and found FoxM1 was overexpressed in NPC cell lines and could be stimulated by cisplatin. MTT and clonogenic assays, flow cytometry, ${\gamma}H2AX$ immunofluorescence, qRT-PCR, and western blotting revealed that downregulation of FoxM1 sensitized NPC cells to cisplatin and reduced the repair of cisplatin-induced DNA double-strand breaks via inhibition of the MRN (MRE11-RAD50-NBS1)-ATM axis, which might be related to the ability of FoxM1 to regulate NBS1. Subsequently, we demonstrated that enhanced sensitivity of FoxM1 knockdown cells could be reduced by overexpression of NBS1. Taken together, our data demonstrate that downregulation of FoxM1 could improve the sensitivity of NPC cells to cisplatin through inhibition of MRN-ATM-mediated DNA repair, which could be related to FoxM1-dependent regulation of NBS1.

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

  • Jeppe Holm Rasmussen;Maise Hoeigaard Fredgart;Jes Sanddal Lindholt;Jens Brock Johansen;Niels Sandgaard;Abdulrahman Haj Yousef;Selma Hasific;Pernille Sonderskov;Flemming Hald Steffensen;Lars Frost;Jess Lambrechtsen;Marek Karon;Martin Busk;Grazina Urbonaviciene;Kenneth Egstrup;Axel Cosmus Pyndt Diederichsen
    • Journal of Cardiovascular Imaging
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    • v.30 no.1
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    • pp.62-75
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    • 2022
  • BACKGROUND: Due to its location very close to the bundle of His, mitral annulus calcification (MAC) might be associated with the development of atrioventricular (AV) conduction disturbances. This study assessed the association between MAC and AV conduction disturbances identified by cardiac implantable electronic device (CIED) use and electrocardiographic parameters. The association between MAC and traditional cardiovascular risk factors was also assessed. METHODS: This cross-sectional study analyzed 14,771 participants, predominantly men aged 60-75 years, from the population-based Danish Cardiovascular Screening trial. Traditional cardiovascular risk factors were obtained. Using cardiac non-contrast computed tomography imaging, MAC scores were measured using the Agatston method and divided into absent versus present and score categories. CIED implantation data were obtained from the Danish Pacemaker and Implantable Cardioverter Defibrillator Register. A 12-lead electrocardiogram was available for 2,107 participants. Associations between MAC scores and AV conduction disturbances were assessed using multivariate regression analyses. RESULTS: MAC was present in 22.4% of the study subjects. Participants with pacemakers for an AV conduction disturbance had significantly higher MAC scores (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.01-1.23) than participants without a CIED, whereas participants with a CIED for other reasons did not. Prolonged QRS-interval was significantly associated with the presence of MAC (OR, 1.45; 95% CI, 1.04-2.04), whereas prolonged PQ-interval was not. Female sex and most traditional cardiovascular risk factors were significantly associated with high MAC scores. CONCLUSIONS: MAC was associated with AV conduction disturbances, which could improve our understanding of the development of AV conduction disturbances.