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Annual Open Heart Surgery: Report of 416 Cases in 1980 (연간 개심술 416례 보고 [1980 년도])

  • 이영균
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.17-25
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    • 1981
  • In 1980, 416 cases of open heart surgery were done in this Department with over all operative mortality of 12.3%. 1. There were 288 congenital anomalies consisting of 174 acyanotic and 114 cyanotic varieties, which showed operative mortality of 6.9% and 25.4% respectively. 2. There were 128 cases of acquired lesions, 124 valvular disease and 3 myxoma being the main lesions. 3. There were 128 cases of valve replacement with operative mortality of 7.8%. 4. The most frequently operated anomaly was VSD, 90 pure VSD and 21 cases were associated with one or 2 cardiac anomalies. Over all operative mortality in 111 VSD cases was 8.1% but in 90 pure VSD cases it was 6.7%. 5. Tetralogy of Fallot showed the highest incidence in cyanotic group with 88 cases, consisting of 68 pure and 20 with other cardiac anomalies. Over all mortality in 88 cases was 19.3% but in pure form 16.2%. 6. In 128 valve replacement cases over all mortality was 9.4%. There were 85 mitral, 11 aortic, 2 tricuspid, 21 mitral with aortic, 6 mitral with tricuspid, 3 mitral, aortic, and tricuspid valve replacement cases. For mitral valve replacement operative mortality was 5.9%. 7. Twenty-one cases of babies under 10kg body weight were operated on with over all operative mortality of 28.6%. Sixteen cases of VSD were found with operative mortality of 25%. 8. Among 128 cases of valve replacement 7 were under the age of 15 years and 12 were between 15 and 20 years old. Five pediatric cases underwent mitral valve replacement without mortality, 9 year old boy was the youngest among them. In this Department open heart surgery for infancy and complex anomalies showed still hip operative risk which should be improved in the coming years. For open heart surgery Shiley oxygenators and 2 sets of A-O de-lux 5 head roller pump were utilized exclusively. For valve replacement Ionescu-Shiley bovine pericardial xenografts were mainly used. In pediatric and rural patients Persantin with aspirin regimen was satisfactorily administered for anticoagulation after valve replacement. Routinely Coumadin was administered for one year after valve replacement* In patients who had thrombus on valve sites, chronic atrial fibrillation, and giant left atrium Persantin-Aspirin regimen was used when one year coumadin administration was discontinued.

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The Role of Intraoperative Echocardiograpby after Repair of Complete Atrioventricular Septal Defect (완전방실중격결손증 수술후 심에코도의 역할)

  • 홍유선
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.902-906
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    • 1994
  • Between May 1991 and August 1993, 16 patients underwent repair of complete atrioventricular septal defect without another major anomaly at Cardiovascular Center,Yonsei University College of Medicine. Ages of the patients ranged from 3 months to 38 years with a mean of 42 months. Among 16, 10 patients[63%] are associated with Down`s syndrome. All patients underwent primary repair except and one who received had been repaire of coactation of aorta and patent ductus arteriosus 2 month before. Preoperative mitral valve regurgitation [MR] was evaluated with Doppler echocardiography and angiography which revealed absent or grade I in 1, grade II in 8, grade III in 4, and grade IV in 3. Operative technique was performed under the moderate hypothermic cardiopulmonary bypass with crystalloid cardioplegia. Intraoperative echocardiography was performed epicardial approach [n=7] in the operative table or transthoracic approach [n=9] at intensive care unit. In all patients except 3, MR were improved. But in 3 patients, was not improved or exagerated comparing preoperative one. All of them were died.One patient was showed MR grade IV in intraoperative echocardiography, we re-repaired atriventricular valve with cardiopulmonary bypass. During follow-up period [at a mean of 11 months after repair], doppler echocardiography was performed in all patients. The follow up echocardiography revealed that the degree of MR in immediate postoperative period was not changed except in two patients in whom it was aggravated. Thus it seems that intraoperative and early postoperative echocardiography was employed important role of survival and can be predictable for long term results.

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METRIC FOLIATIONS ON HYPERBOLIC SPACES

  • Lee, Kyung-Bai;Yi, Seung-Hun
    • Journal of the Korean Mathematical Society
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    • v.48 no.1
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    • pp.63-82
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    • 2011
  • On the hyperbolic space $D^n$, codimension-one totally geodesic foliations of class $C^k$ are classified. Except for the unique parabolic homogeneous foliation, the set of all such foliations is in one-one correspondence (up to isometry) with the set of all functions z : [0, $\pi$] $\rightarrow$ $S^{n-1}$ of class $C^{k-1}$ with z(0) = $e_1$ = z($\pi$) satisfying |z'(r)| ${\leq}1$ for all r, modulo an isometric action by O(n-1) ${\times}\mathbb{R}{\times}\mathbb{Z}_2$. Since 1-dimensional metric foliations on $D^n$ are always either homogeneous or flat (that is, their orthogonal distributions are integrable), this classifies all 1-dimensional metric foliations as well. Equations of leaves for a non-trivial family of metric foliations on $D^2$ (called "fifth-line") are found.

Operative treatment of pectus excavatum -7 cases used retrosternal metal bar- (누두흉의 외과적 치료 -Metal bar를 이용한 수술치험 7예-)

  • 이정철
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.391-398
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    • 1986
  • From Jan. 1983 to Dec. 1985, seven cases of pectus excavatum, six were male and one female, were underwent an operation at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital. The ages of patients ranged from 6 to 27 years. They all had symptoms of feeling inferiority about chest deformity. The concavity on the funnel chest varied in its extent, and the severity, which was measured by water volume filled into it, varied from 59.5cc/m2 to 129.9cc/m2. All but one patients were approached through a bilateral transverse submammary incision and one approached through a vertical midline incision. Successful surgical correction required resection of all deformed costal cartilages with transverse anterior osteotomy and internal fixation using retrosternal metal bar. No serious complication have followed the use of this technique, but minor complications such as serous accumulation, pneumothorax and strut migration have been experienced. All patients were satisfactory about the surgical results.

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One-stage Reverse Lateral Supramalleolar Adipofascial flap for Soft Tissue Reconstruction of the Foot and Ankle Joint (족부 및 족관절 주위 연부조직 재건을 위한 일단계 역행성 외측 과상부 지방근막 피판술)

  • Kwon, Boo-Kyung;Chung, Duke-Whan;Lee, Jae-Hoon;Choi, Il-Hoen;Song, Jong-Hoon;Lee, Sung-Won
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.93-99
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    • 2007
  • Purpose: To report the clinical results and efficacies of one stage reverse lateral supramalleolar adipofascial flap for soft tissue reconstruction of the foot and ankle joint. Material and Methods: We performed 5 cases of one stage reverse lateral supramalleolar adipofascial flap from Jan 2005 to Sept 2005. All patients were males and mean age was 50(36~59) years old. The causes of soft tissue defects were 1 diabetic foot, 2 crushing injuries of the foot, 1 open fracture of the calcaneus, and 1 chronic osteomyelitis of the medial cuneiform bone. Average size of the flap was 3.6(3~4)${\times}$4.6(4~6) cm. All flaps were harvested as adipofascial flap and were performed with the split-thickness skin grafts (STSG) above the flaps simultaneously. Results: All flap survived completely and good taking of STSG on the flap was achieved in all cases. There were no venous congestion and marginal necrosis of the flap. In diabetic foot case, wound was healed at 4 weeks after surgery due to wound infection. There was no contracture on the grafted sites. Ankle and toe motion were not restricted at last follow up. All patients did not have difficulty in wearing shoes. Conclusion: The reverse lateral supramalleolar adipofascial flap and STSG offers a valuable option for repair of exposure of the tendon and bone around the ankle and foot. Also one stage procedure with STSG can give more advantages than second stage with FTSG, such as good and fast take-up, early ambulation and physical therapy, and good functional result.

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Sclerotherapy of Peritoneal Inclusion Cysts: Preliminary Results in Seven Patients

  • Jun Yong Jeong;Seung Hyup Kim
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.164-170
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    • 2001
  • Objective: To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). Materials and Methods: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. Results: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. Conclusion: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.

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Characteristics of Strong Alkaline Electrolyzed Water Produced in All-in-one Electrolytic Cell (일체형 전해조에서 생산된 강알카리성 전해수의 특성)

  • Lee, Ho Il;Rhee, Young Woo;Kang, Kyung Seok
    • Clean Technology
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    • v.18 no.4
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    • pp.446-450
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    • 2012
  • Strong alkaline electrolyzed water which is produced in cathode by electrolyzing the solution where electrolytes (NaCl, $K_2CO_3$ etc.) are added in diaphragm electrolytic cell, is eco-friendly and has cleaning effects. So, it is viewed as a substitution of chemical cleaner. In addition, strong alkaline electrolyzed water is being used by some Japanese automobile and precision parts manufacturing industries. When strong alkaline electrolyzed water is produced by using diaphragm electrolytic cell, it is necessarily produced at the anode side. Since strong acidic electrolyzed water produced is discarded when its utilization cannot be found, production efficiency of electrolyzed water is consequently decreased. Also, there is a weakness electrolytic efficiency is decreasing due to the pollution of diaphragm. In order to overcome this, non-diaphragm all-in-one electrolytic cell integrated with electrode reaction chamber and dilution chamber was applied. Strong alkaline electrolyzed water was produced for different composition of electrolytes, and their properties and characteristics were identified. In comparing the properties between strong alkaline electrolyzed water produced in diaphragm electrolytic cell and that produced in all-in-one electrolytic cell, the differences in ORP and chlorine concentration were found. In emulsification test to confirm surface-active capability, similar results were obtained and strong alkaline electrolyzed water produced in non-diaphragm all-in-one electrolytic cell was identified to be useable as a cleaner like strong alkaline electrolyzed water produced in diaphragm electrolytic cell. Strong alkaline electrolyzed water produced in non-diaphragm all-in-one electrolytic cell is thought to have sterilizing power because it has active chlorine which is different from strong alkaline electrolyzed water produced in diaphragm electrolytic cell.

COMINIMAXNESS WITH RESPECT TO IDEALS OF DIMENSION ONE

  • Irani, Yavar
    • Bulletin of the Korean Mathematical Society
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    • v.54 no.1
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    • pp.289-298
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    • 2017
  • Let R denote a commutative Noetherian (not necessarily local) ring and let I be an ideal of R of dimension one. The main purpose of this note is to show that the category ${\mathfrak{M}}(R,\;I)_{com}$ of I-cominimax R-modules forms an Abelian subcategory of the category of all R-modules. This assertion is a generalization of the main result of Melkersson in [15]. As an immediate consequence of this result we get some conditions for cominimaxness of local cohomology modules for ideals of dimension one. Finally, it is shown that the category ${\mathcal{C}}^1_B(R)$ of all R-modules of dimension at most one with finite Bass numbers forms an Abelian subcategory of the category of all R-modules.

Arterial Switch Operation for Transposition of The Great Arteries with Ventricular Septal Defect and for Double Outlet Right Ventricle with Subpulmonary Venricular Septal Defect (심실중격결손증을 동반한 대혈관 전위증 및 양대동맥 우심실 기시증에 대한 동맥전환술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1118-1127
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    • 1990
  • Arterial switch operation for repair of nineteen cases of transposition of the great arteries associated with ventricular septal defect and three cases with double outlet right ventricle with subpulmonary ventricular septal defect[Taussig-Bing type DORV] was performed from November 1987 to September 1990 at the Seoul National University Children`s Hospital. Sixteen of them were under six months of age, and three were under one year of age with body weight ranged from three to fourteen kilograms. Preoperative cardiac catheterization was done in eighteen patients, in which the pressure of the left ventricle was greater than 70% of the right ventricle in all but one. Patent ductus was associated in thirteen cases[68.4%] of TGA+VSD, and atrial septal defect or patent oval foramen was in sixteen cases. Four atrial septostomy, one modified Blalock- Taussig shunt, one pulmonary artery banding, one coarctoplasty using subclavian arterial flap, were perfomed before arterial switch operation. There were five hospital deaths, all in the. patients with transposition of the great arteries with ventricular septal defect[overall mortality rate 22.7%]. Lecompte Maneuver was used in all patients, and in all patient the U-shaped flap of coronary arteries were transposed to V-shaped cleavage created in the neoaorta. Arterial defect in the neopulmonary artery was covered with 0.0625% Glutaraldehyde fixed autogenous pericardium There have been no late deaths, Postoperative cardiac catheterization and angiocardiogram in four patients has revealed no stenosis in the neopulmonary artery or neoaorta with reasonable P[RV/LV], Anatomic correction for transposition and double outlet right ventricle with subpulmonary ventricular septal defect would seem to be a good operative alternative to intraatrial switch procedures, with the advantage of incorporating the left ventricle to systemic circulation.

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Pulmonary Resections Using Bronchoplastic Procedures (기관지 성형술을 이용한 폐엽 절제술)

  • Kim, Ju-Hyeon;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.616-620
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    • 1992
  • A sleeve lobectomy is an appropriate operative procedure in patients with endobronchial neoplasms of low-grade malignancies in the proximal airways and for a small but significant number of patients with carcinoma. Here, we present eleven cases of sleeve lobectomy which were performed from 1984 to the August of 1991 in the Department of Thoracic Surgery of Seoul National University Hospital. The sex distribution was 6 males and 5 females in the age range from twenty to sixty seven, with an average of 44.9 years. The pathologic diagnoses were 7 cases of pulmonary malignancies: carcinoid in two, mucoepidermoid carcinoma in two, adenoid cystic carcinoma in one, adenocarcinoma in one, and squamous carcinoma in one. Other diagnoses were two cases of tuberculous bronchial strictures and two cases of benign tumors: one case of pesudolymphoma and one case of neurilemmoma. The procedures consisted of five right upper sleeve lobectomies [Fig. 1], four left upper sleeve lovectomies [Fig. 2], one left lower sleeve lobectomy[Fig. 3], and one right middle and lower lobetomy [Fig. 4]. All except one had a normal preoperative pulmonary function. The case which had a poor pulmonary function was a 66-year-old female adenocarcinoma patient. She seemed to be very intolerable to pneumonectomy [predicted FEV1=0.60L]. Therefore, she had a right sleeve upper lobectomy and experienced smooth postoperative course without any pulmonary problems. All cases had good postoperative results and no postoperative complications.

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