• Journal of Chest Surgery
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• v.22 no.1
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• pp.50-58
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• 1989

The emergence and expansion of cardiac surgery over the past decade has resulted in an increasing number of patients undergoing cardiac operations but many kinds of heart surgery was realized only palliative, resulting in increasing numbers of secondary cardiac procedures. From 1978 to 1988, 10 cases of various congenital heart diseases and 17 cases of acquired heart diseases were reoperated at Hanyang University Hospital. The leading indication of second operation was residual shunt or valvular malfunction due to technical failure in congenital heart disease and primary valve failure, endocarditis, paravalvular leakage were for acquired heart disease. The mortality of reoperation was 0% for congenital heart disease and 11.7%[2 death among the 17 patients] for acquired heart disease. The leading causes of death were myocardial failure, sepsis with endocarditis, acute renal failure and congestive heart failure.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.177-181
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• 1998

Provox is now widely used for voice rehabilitation for total laryngectomized patient because of its low airway resistance and easiness for phonation. This study was designed to reveal the influence of radiation therapy on Proven complications. Forty-four patients who underwent total laryngectomy were grouped into group A (no radiation), group B(radiation and then Provox insertion), group C(Proven insertion and then radiation). Provox complications were leakage, granulation tissue formation, malfunction and infection. The average survival time of Provox was longer in group C (9.2 me) than group A(8.6 m) or group B (7.3 me), but no statistical significance was found. The first time of Provox change was 10.2, 8.6 and 9.7 months respectively. The incidence of complication was not significantly different among groups. The cases of Provox remeval due to shunt failure were 5, 4 and 2 respectively. Even though a significant statistically difference was not found partialy due to the small numbers of patients, a special caution should be exercised in inserting Provox to prevent a serious complication for the patients who had a history of previous radiation.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.644-649
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• 2000

Objective : Acute hydrocephalus can be caused by many pathologic conditions such as sub- arachnoid hemorrhage, intraventricular hemorrhage, inflammatory diseases. External ventricular drainage(EVD) through trephination of the skull is essential procedure for progressing or persistent symptomatic acute hydrocephalus. If the EVD can not be removed in short period, the chance of ventriculitis increases and periodic transposition of the draining catheter should be considered. Shunt procedure can not be performed in acute hemorrhage or infectious condition because of the risk of shunt malfunction or intra-abdominal spreading of the infection, respectively. The authors replaced EVD with continuous lumbar drainage(CLD) for the purpose of controlling acute hydrocephalus and preventing ventriculitis simultaneously, or treating ventriculitis more effectively in case of infection which had already broken out. CLD has many advantages over EVD, although, it can complicate disastrous downward brain herniation in patients with elevated intracranial pressure. The authors performed CLD with EVD maintained and then tested the possibility of the brain herniation with quite simple method. If the CLD was proven as safe through the test, EVD could be replaced with it without terrible herniation. Material and Method : Between September 1998 and April 1999, 10 patients underwent CLD in replacement of EVD. Among them, 5 were patients with aneurysmal subarachnoid hemorrhage, 2 were patients with thalamic hematoma and intraventricular hemorhage and 3 were patients with traumatic intracranial hemorrhage. Results : In eight of them the replacements were successfully done and one of them died on account of medical illness. In two of them the replacement could not be performed because of the risk of herniation and all expired owing to ventriculitis. Two patients required permanent shunt operation. Conclusion : This article provides a valuable alternative method of treatment for persistent symptomatic hydrocephalus which can not be managed with shunt operation immediately.