• Journal of Chest Surgery
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• v.15 no.4
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• pp.381-386
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• 1982

Pulmonary artery aneurysm usually carries an ominous prognosis due to the associated pulmonary hypertension. In July 1981, a patient with a huge aneurysm of main pulmonary artery secondary to pulmonary hypertension and bacterial endocarditis due to a patent ductus arteriosus was treated by resection of the aneurysm and Dacron patch graft replacement and closure of the patent ductus arteriosus. The immediate postoperative result was excellent. We now report the surgical treatment, clinical course, and one and half years follow up of the patient.

• Journal of Chest Surgery
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• v.16 no.4
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• pp.492-497
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• 1983

24 cases of patent ductus arteriosus were experienced from Aug. 1977 to October 1983, at the department of thoracic surgery. Chungnam National University Hospital. Patent ductus arteriosus is one of the common congenital heart disease and the diagnosis can be made easily and simply. Interruption is done by thoracic surgeons and it is considered on of the simple separation. 1. Age ranged from 10 month old to 19 year old. 2. Sex ratio [male to female] was 1:2. 3. Diagnosis was made by the finding of the physical examination, chest X-ray, E.K.G., and Cardiac catheterization. 4. Operation was performed with double ligation and transfixion suture ligation at 23 cases, division was one case. 5. Postoperative recanalization was occurred in one patient, who had subacute bacterial endocarditis.

• International Journal of Oral Biology
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• v.36 no.4
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• pp.163-166
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• 2011

Oral viridans streptococci are recognized as one of the etiological agents of a variety of infectious diseases such as dental caries and infective endocarditis. Although antimicrobial susceptibility tests for these fastidious bacterial species are now established and standardized, a comparison between the broth microdilution and broth macrodilution tests has not previously been performed. This comparison was performed in the present study using the tests adopted by the Clinical and Laboratory Standards Institute (CLSI) and seven clinical isolates of oral viridans streptococcal strains. A modified broth macrodilution susceptibility test method was also included in this analysis, in which the media was not supplemented with horse blood. The susceptibility interpretation category agreements were measured at 83% (broth microdilution versus broth macrodilution) and 71% (broth microdilution versus modified broth macrodilution). The interpretation category agreement between the broth macrodilution and modified broth macrodilution tests was also 83%. These data indicate that the interpretation of antibiotic susceptibility test results for oral viridans streptococci are influenced by the methods used.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.649-654
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• 1985

After first successful mitral valvotomy by Harken and Bailey in 1948, improvement of surgical technique and cardiac device may last rapidly for several years, but there after many patients deteriorate because of various causes, so incidence of reoperation for cardiac valvular disease has increased time by time. This paper is concerned with 21 patients in whom a second operation has been carried out from Jan. 1963 to Aug. 1984 at the department of Thoracic and Cardiovascular department, National Medical Center. Of 21 patients, 7 were male and 14 were female, and ages ranged from 14 to 37 years The second operation are classified into groups of secondary closed mitral commissurotomy [3 cases], open commissurotomy following closed mitral commissurotomy [1 case], Valve replacement following closed mitral commissurotomy [14 cases] or bioprosthetic valve replacement [3 cases]. Main cause of reoperation was restenosis or steno insufficiency, and that of bioprosthetic valve failure was bacterial endocarditis [1 case], fibrous tissue overgrowth on the Xenograft [1 case] and technical failure [1 case]. Early operative mortality was absent, but during follow-up, 4 patients died, so late mortality was 19.0%, and main cause of death was congestive heart failure.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.704-707
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• 1995

The use of the patient`s pulmonary valve for replacement of the patient`s diseased aortic valve was introduced and developed by Mr. Donald Ross. The long term benefits of having a normal, fully viable, trileaflet semilunar valve in aortic position was demonstrated. A 38 year old male had histories of failures of previously implanted aortic prosthetic valves twice and evidence of progressive heart failure. At operation, aortic root abscess was found; the abscess extension to adjacent structures and partial valve dehiscence had occurred. The patient underwent replacement of the aortic root with autologous pulmonary valve, autologous pericardial patch repair of left ventricuar outflow tract and recontruction of the right ventricular outflow tract and pulmonary artery with prosthetic valved conduit. Postoperatively, the patient recovered well. Postoperative doppler echocardiography demonstrated minimal central regurgitation in new aortic valve. Aortic root replacement with pulmonary autograft in a patient of recurrent aortic root abscess and false aneurysm of left ventricuar outflow tract was experienced and reported with follow up echocardiography.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.444-450
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• 1994

From June 1984 to February 1994, cardiac valve replacement was performed in 108 patients. The distribution of patients was ranged from 13 to 64 year-old age[mean 39.48 1.24] and 51 patients were male, 57 patients were female [male:female=1:1.1]. 64 patients had mitral valve replacement, 27 patients underwent aortic valve replacement and 17 patients were performed double[mitral & aortic] valve replacement. Total 125 artificial cardiac valves were used, mechanical valves were 51 valves and tissue valves were 74 valves. The duration of follow-up was 473.41 patient-year[mean 4.79 3.29 patient-year] and the information of follow-up was available for 99 patients[92%]. The actuarial survival rates including the operative mortality was 89.5% & 88.3 at postoperative fourth & ninth year. The probability of freedom from overall valve failure, thromboembolism and bacterial endocarditis were 77.5%, 89.2% and 95.6% at ninth year after cardiac valve replacement.

• Microbiology and Biotechnology Letters
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• v.49 no.4
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• pp.467-477
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• 2021

Staphylococcus aureus is a well-known pathogen that can cause diseases in humans. It can cause both mild superficial skin infections and serious deep tissue infections, including pneumonia, osteomyelitis, and infective endocarditis. To establish host infection, S. aureus manages a complex regulatory network to control virulence factor production in both temporal and host locations. Among these virulence factors, staphyloxanthin, a carotenoid pigment, has been shown to play a leading role in S. aureus pathogenesis. In addition, staphyloxanthin provides integrity to the bacterial cell membrane and limits host oxidative defense mechanisms. The overwhelming rise of Staphylococcus resistance to routinely used antibiotics has necessitated the development of novel anti-virulence agents to overcome this resistance. This review presents an overview of the chief virulence determinants in S. aureus. More attention will be paid to staphyloxanthin, which could be a possible target for anti-virulence agents.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.959-963
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• 1996

St. Jude Medical bileaflet valve was implanted in 42 patients from September, 1988, to July, 199)(mitral valve replacement in 25, aortic valve replacement in 11, multiple valve replacement in 6). Concomitant procedures were performed in 5 patients(11.9%). The early mortality was 4.8%(2 patients) and the late mortality was 9.5%(4 patients). The valve-related causes of late mortality were prosthetic valve endocarditis(threi), unknown(one). There was no instance of structural failure. Follow up was 100% complete, with 179.8 patient-years and a mean follow up of 54 months(from 1.5 to 84 months). The overall actuarial survival rates was 90$\pm$4.7% at 5 years. At 5 years, the acturarial freedom from valve failure was 90$\pm$4.7%, 89.7$\pm$4.5% from thromboembolism and 92.3 $\pm$4.2% from bacterial endocarditis, respectively.

• International Journal of Oral Biology
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• v.30 no.4
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• pp.125-130
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• 2005

Thrombin-induced platelet microbicidal proteins (tPMP) are antibacterial proteins released when platelets are stimulated by thrombin. It has been reported that tPMP has antibacterial activity against various bacterial species including causative agents of infective endocarditis. Most of the oral streptococci have resistance to the killing by tPMP and this fact may play an important role as a virulence factor in infective endocarditis. However, the susceptibility and resistance mechanism of oral streptococci for tPMP have not been revealed yet. In this study, the killing mechanism of tPMP for oral streptococci has been investigated. Streptococcus rattus BHT, a susceptible strain, and Streptococcus gordonii DL1, a resistant strain, have been used in this study. tPMP was isolated from platelet after stimulation with thrombin. Cell membrane depolarization was examined with 3,3'-dipropylthiodicarbocyanine iodide ($DiSC_3$), membrane potential-sensitive cyanine dye, by fluorescence spectrophotometry. The permeabilization of cell membrane by tPMP was investigated with propidium iodide (PI) by flow cytometry. tPMP susceptible S. rattus BHT showed the increase of the $DiSC_3$ fluorescence level meaning depolarization of cell membrane and increase of the uptake of PI which means permeabilization of cell membrane. However, tPMP resistant S. gordonii DLI did not show depolarization and permeabilization. These results indicate that the increasing depolarization and permeabilization of oral streptococcal cell membrane are associated with the bactericidal activity of tPMP.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.815-818
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• 1997

Prosthetic valve endocarditis(PVE), although uncommon, is associated with significant mortality if the infection spreads into the paravavular structures with later abscess formation. However, combined antibiotic and surgical treatment is often successful. Accurate diagnosis by on echocardiography, effective myocardial protection during operation and increased surgical experience have improved the short-term and long-term outcomes for patients with PVE. A 35-year-old male had a history of replacement of aortic and mitral valve, and tricuspid annuloplasty on August 1994, was admitted due to sudden onset of aphasia, leftward deviation of both eyeballs and spiking fever and diagnosed of having PVE by echocardiography. Reoperation was done after 6weeks of antibiotic treatment. On the operative field, we could notice circumferential vegetation along aortic valve annulus, paravalvular leakage and abscess pocket. The mitral valve amlulus was healthy. The patient underwent redo aortic valve replacement using cryopreserved aortic homograft after radical debridement of infected issue. During the follow up of 7 months period the homograft was well functioning without recurrence of symptoms.