• Journal of Chest Surgery
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• v.16 no.2
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• pp.157-163
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• 1983

Ebstein's anomaly is a rare congenital cardiac malformation oand the ideal surgical correction seems controversial at present, and some problems are left unsolved in the surgical correction of this anomaly. Between June 1978 and June 1982, 12 patients with Ebsteins' anomaly underwent corrective open heart surgery at Seoul National University Hospital. Except for one patient, who had no ASD, all had a huge right atrium, secundum type ASD, and definite atrialized right ventricle. Typically, displaced tricuspid valve leaflets were found in all cases, but the degree of displacement and deformity were variable. In the point of NYHA functional classification, five were in class II, six were in class III, and one was in class IV. Ten patients were operated on by tricuspid valve replacement and pication. Two patients were operated on only by plication and annuloplasty techniques, and in all cases, ASD was closed. Postoperatively, four patients suffered from complete A-V block, and two of them died immediately. The remaining two patients took pacemaker generator implantation with good results. The other eight patients were in good condition. Tricuspid valve replacement using tissue valve and plication of the atrialized rght ventricle seems to be a good method of surgical correction for Ebstein's anomaly.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1202-1206
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• 1996

Ebstein's anomaly is an unusual and a rare congenital cardiac malformation but characteristic abnormality of the development of the tricuspid valve, right atrium and ventricle. The characteristic findings are a displaced tricuspid valve with a septal leaflet spiralling into the right ventricle. The surgical correction is variable and are left unsolved problem in surgical treatment of anomaly. Between January 1988 ＆ December 1995, we experienced 11 cases of Ebstein's anomaly and associated cardiac anomalies are ASD, PFO, ASD with VSD. The typically displaced tricuspid valve leaflet was found in all cases. In the NYHA functional classification, three were in class II, seven were in class III, and one was in class IV. Nine patients were operated by tricuspid annuloplasty ＆ plication with Danielson's method and two patients were done by tricuspid valve replacement with plication, and in all cases associated anomaly was corrected. Postoperatively, five patients suffered from complication - low cardiac output syndrome, arrhythmia and wound infection. There was no operative mortality and the postoperative courses were relatively good conditions with more improvement of symptoms.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.221-228
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• 2005

Reduction aortoplasty has been advocated for dilatation of the ascending aorta associated with aortic valve disease in older, high-risk patients. We report our results with modification of reduction aortoplasty and aortic valve replacement. Material and Method: Between July 2001 and December 2002, 14 consecutive patients who underwent modification of reduction aortoplasty, suture plication technique without excision of the dilated aortic wall, were reviewed. The mean age was 63.7$\pm$6.7 (50 to 75) years. Ten patients had congenital bicuspid aortic valve, Twelve patients had severe aortic valve stenosis and 6 had regurgitation of grade III$\~$IV. The diameter of the ascending aorta was measured before and immediately after surgery and 6 and 12 months postoperatively using echocardiography or computed tomography. Follow-up was complete in an average of 14.7$\~$5.4 (7 to 24) months. Result: There were no early postoperative deaths and no bleeding complications. Reduction aortoplasty with suture plication technique decreased the diameter of ascending aorta from 49.4$\pm$3.5 mm preoperatively to 33.2$\pm$3.4 mm postoperatively (p <0.001). During follow-up, there were no late deaths and no aneurysm recurrence on the ascending aorta. Conclusion: Suture plication technique of reduction aortoplasty without excision of the dilated aortic wall offers good early and short-term results in older, high-risk patients with dilatation of the ascending aorta associated with aortic valve disease. Surgical long-term results of our technique should be evaluated in further studies.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.580-585
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• 2008

Background: Many types of tricuspid annuloplasty are used in surgical correction of functional tricuspid regurgitation (FTR). We evaluated the mid-term and long-term outcomes in patients treated with a posterior annular plication technique (a modified Davila technique) for FTR. Material and Method: Between January 1991 and August 2006, 58 adult patients (male, 22; female, 36) with FTR of grade 2/4 or more or with tricuspid annular dilatation of more than 5.0cm in diameter, even with an FTR of less than grade 2, had received a posterior annular placation. Preoperatively, 26 patients (44.8%) had a grade 3 or more FTR. All patients had received a mitral valve replacement, and 20 (34.5%) had concomitant aortic valve replacement. Result: During the mean follow-up period of $101.4{\pm}51.6$ months, FTR disappeared or remained trivial in 28 patients (49.1%), was grade $2{\sim}3$ (${\geq}$grade 2 and $2.66{\pm}0.73\;vs.\;0.82{\pm}0.89$; p<0.0001). Patients did not require a second surgery for FTR and did not show further FTR aggravation. Conclusion: The modified Davila posterior annular plication technique for FTR has reasonable mid-term and long-term results and is a useful surgical procedure.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.813-816
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• 2004

The conformation of traumatic diaphragmatic rupture is frequently difficult, even if radiologic evaluation has been performed. A 37-year old man with multiple trauma was suspicious with diaphragmatic rupture. The diaphragmatic rupture could not be confirmed with chest CT. We decided thoracoscopic operation for diagnosis. Diaphragm was ruptured about 8 cm length involving entering site of phrenic none into diaphragm and diaphragmatic paralysis was combined. We made 5 cm sized working window additionally. Ruptured diaphragm was repaired by continuous suture and plication of diaphragm was performed. Postoperative result was good at chest radiogram after three monthes.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.985-990
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• 2003

Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, corvical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an on-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.266-270
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• 1993

Aortic valve insufficiency with ventricular septal defect is usually treatment by plication of prolased cusps. We have performed the aortic valvuloplasty by the Trusler`s method in 14 patients of ventricular septal defect associated with aortic insufficiency. The reoperations were performed in the 4 cases[29%] due to recurrent aortic insufficiency after aotic valvuloplasty. Two patients underwent aoritc valvular replacements for the tears of repaired aortic cusps after primary aortic valvuloplasty for aortic insufficiency. The other two patients had aortic valvuloplasties again. Death occured in one case of aortic valvular replacements. The cause of death was low cardiac output syndrome soon after aortic valvular replacement for recurrent aortic insufficiency .

• Journal of Plant Biology
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• v.39 no.3
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• pp.215-221
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• 1996

Sorghum leaf tissues showing the early acute response of systemic infection with maize dwarf mosaic virus (MDMV) strain A, contained unusual virus-induced cytological modifications including cell wall thickenings and protrusions, intercellular vesicles termed as "paramural bodies", modified plasmodesmata, abnormal plastids, and cylindrical inclusion bodies. Abnormal cell wall, some of which associated with paramural bodies, was frequently contained modified plasmodesmata. Various abnormal plastids were located within infected cells of leaf tissues showing the early acute response. The most important changes in chloroplast seen in the tissues are the presence of small vesicles, deformation of membranes, reduction in granal stack height, disappearance of osmiophilic globules and degeneration of stuctures. The cytological modification was not occurred in nucleus but a group of degenerated mitochondria with abnormal membranes attached to cylindrical inclusion bodies were observed. It was hard more or less to prove the relationship clearly between virus and cellular organelles in virus replication.plication.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.391-397
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• 1985

Ebstein`s anomaly is a rare congenital cardiac malformation and characterized by downward displacement of an abnormal tricuspid valve cusps. But until now, the ideal surgical correction is still controversial. We present a case of Ebstein`s anomaly experienced lately. The patient was 13 year old girl with the complaints of dyspnea on exertion, fatigability and cyanosis. Echocardiography revealed downward displacement of septal leaflet of tricuspid valve and atrialized right ventricle. Cardiac catheterization and cineangiography revealed ASD and large right atrium. During operation, the atrialized right ventricle was plicated and tricuspid annuloplasty was done. And the two secundum type ASD`s were closed by direct suture closure. The patient`s postoperative course was uneventful and discharged on the 24th postoperative days.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.135-142
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• 1991

From January 1980 to December 1989, thirteen patients underwent operation for ventricular septal defect associated with aortic insufficiency in Kyungpook national university hospital. Ten male and three female patients ranged in age from 3 years to 25 years, with an average age of 11.5 years. Aortic cusp prolapse was found in eight cases[61.5%]. The aortic regurgitation was classified by Sellers` method with grade I in 2 cases, grade II in 9 cases, and grade III in 2 cases. Direct suture or patch repair of ventricular septal defect was performed through the right ventricle. Eight cases were treated only by closure of VSD, 3 cases by plication, but two of the letter were reoperated due to the persistent of aortic regurgitation and fungal endocarditis respectively. Aortic valve replacement were performed in 2 cases at the first operation. There was only one late death[7.7%], which was caused by postoperative fungal endocarditis. Follow-up for twelve patients except one death were followed up for 3 months to six years after operation. Residual aortic regurgitation was noted in six cases[46.2%], but the postoperative course of them were uneventful.