• Journal of Chest Surgery
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• 제35권1호
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• pp.48-51
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• 2002

폰탄수술 중 초기의 우심방-폐동맥 문합방식으로 시행한 환자의 장기추적에서 심방성 부정맥, 심방확장, 폐정맥폐쇄, 심실기능저하 등의 합병증이 발생된 경우 이에 대한 치료법으로 폰탄연결의 재교정이 권장된다. 심방성 빈맥을 동반한 폰탄연결 기능부전 환자에서 그에 대한 치료로서 혈류역학적 효율성이 월등한 것으로 알려진 심장외도관을 이용한 완전 체정맥-폐동맥연결과 부정맥 통로에 대한 냉동절제술의 병행이 선호된다. 본원에서는 삼첨판폐쇄증으로 우심방-폐동맥연결폰탄수술을 받은 후 장기추적 과정 중 이소성 심방빈맥,우심방매혈전, 폐정맥협착, 심실기능저하 등의 합병증이 발생된 환자 1례에서 냉동절제를 병행한 심장외도관 폰탄으로의 전환술을 경험하였기에 보고하는 바이다. 본 증례의 환자와 부모는 여호와의 증인 신자였으며 처치과정 중 수혈은 시행하지 않았다.

• Journal of Chest Surgery
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• 제35권4호
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• pp.303-306
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• 2002

심한 Ebstein기형이 있으면서 신생아시기에 증상이 있는 경우, 심한 심비대를 보이며 이로인해 폐발달의 장애가 생기고 기능적 폐동맥판폐쇄를 보이며, 동맥관의존 폐혈류를 보인다. 지금까지 이런 경우 양심실성교정은 실망적이었으며 근래에 와서 Fontan술식을 목표로 하는 Stames술식으로 좋은 결과를 보고하고 있다. 본원에서는 생후 4일째 심한 심비대와 함께 해부학적 폐동맥판폐쇄가 동반된 Ebstein기형의 환아에서 심방화된 우심실을 수직적 주름성형술, 삼첨판막륜성형술, 우심실유출로재건, 심방중격결손부분폐쇄, 우심방축소술로 양심실고정술을 시행하였다. 술후 환아는 심홉곽비의 현저한 감소와 심초음파검사상 경도의 삼첨판폐쇄부전을 보이며 10개월째 건강한 상태로 외래추적관찰중이다.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.193-195
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• 2018

• Journal of Chest Surgery
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• 제47권6호
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• pp.510-516
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• 2014

Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI. Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was $68.8{\pm}9.5$ years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies. Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions. Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

• Journal of Chest Surgery
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• 제46권4호
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• pp.256-264
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• 2013

Background: Surgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery. Materials and Methods: From 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was $73.1{\pm}47.4$ months. Results: The surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072). Conclusion: In native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.829-834
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• 2013

Background: MicroRNAs are noncoding RNA molecules that posttranscriptionally regulate gene expression. The aim of this study was to determine the role of microRNA-21 in cholangiocarcinomas and its relationship to cholangiocarcinoma RBE cell capacity for invasion and metastasis. Methods: MicroRNA-21 expression was investigated in 41 cases of cholangiocarcinoma samples by in situ hybridization and real-time PCR. Influence on cholangiocarcinoma cell line invasion and metastasis was analyzed with microRNA-21 transfected cells. In addition, regulation of reversion-inducing-cysteine-rich protein with kazal motifs (RECK) by microRNA-21 was elucidated to identify mechanisms. Results: In situ hybridization and real-time quantitative PCR results for patients with lymph node metastasis or perineural invasion showed significantly high expression of microRNA-21 (P<0.05). There was a dramatic decrease in cholangiocarcinoma cell line invasion and metastasis ability after microRNA-21 knockdown (P<0.05). However, overexpression significantly increased invasion and metastasis (P<0.05). Real-time PCR and Western-blot analysis showed that microRNA-21 could potentially inhibit RECK expression in RBE cells. Survival analysis showed that patients with higher expression levels of microRNA-21 more often had a poor prognosis (P<0.05). Conclusions: MicroRNA-21 may play an important role in cholangiocarcinoma invasion and metastasis, suggesting that MicroRNA-21 should be further evaluated as a biomarker for predicting cholangiocarcinoma prognosis.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.377-381
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• 2012

The aim of this study was to screen for polypeptides binding specifically to LoVo human colorectal cancer cells using a phage-displayed peptide library as a targeting vector for colorectal cancer therapy. Human normal colorectal mucous epithelial cells were applied as absorber cells for subtraction biopanning with a c7c phage display peptide library. Positive phage clones were identified by enzyme-linked immunosorbent assay and immunofluorescence detection; amino acid sequences were deduced by DNA sequencing. After 3 rounds of screening, 5 of 20 phage clones screened positive, showing specific binding to LoVo cells and a conserved RPM motif. Specific peptides against colorectal cancer cells could be obtained from a phage display peptide library and may be used as potential vectors for targeting therapy for colorectal cancer.

• 대한족부족관절학회지
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• 제9권1호
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• pp.121-124
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• 2005

The midtarsal joint which consists of the talonavicular and calcaneocuboid joints lies transversely across the medial and lateral arches of the foot. Complete dislocation of this joint unassociated with fracture is extremely rare. A 36 year-old male who was injured by motor vehicle accident came to help for his left midfoot pain and deformity. We misdiagnosed as subtalar dislocation. Closed reduction was performed. We reviewed initial and post-reduction X-rays, and then we diagnosed as Chopart's dislocation. CT scan was taken; it showed fracture of the anterior process of the calcaneous.

• 대한족부족관절학회지
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• 제14권2호
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• pp.173-176
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• 2010

Synovial chondromatosis is a benign lesion forming multiple round cartilagenous nodules or osseous loose bodies in joint cavity. Predilection sites are known as knee, hip and elbow joints. However, the involvement of ankle joint was rarely reported in the literature. Moreover, extraarticular chondromatosis in synovial sheath or bursa of extremities is extremely rare. We present a case of synovial chondromatosis of the left ankle joint and flexor hallucis longus tendon sheath.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.696-700
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• 2022

We performed distal bypass and free flap transfer in a single-stage operation to repair an extensive soft tissue defect in an ischemic foot of an 84-year-old woman. The nutrient artery of the free flap was anastomosed to the bypass graft in an end-to-side manner. Subsequently, the bypass graft became occluded on several occasions. Although intravascular and surgical interventions were performed each time, the bypass graft eventually became completely occluded. However, despite late occlusion of the nutrient artery, the free flap has remained viable and the patient is ambulatory. The time required for a transplanted free flap to become completely viable without a nutrient artery is likely longer for an ischemic foot compared with a healthy foot. However, the exact period of time required is not known. A period of month was required in our patient. We report this case to help clarify the process by which a free flap becomes viable when applied to an ischemic foot.