• Title/Summary/Keyword: preoperative

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Clinical effect of Thymectomy for Patients in Myasthenia Gravis (근무력증 환자의 외과적 치료)

  • 정원상
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.152-157
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    • 1990
  • A clinical study for thymectomy for 23 patients in Myasthenia Gravis was done between May, 1982 and July, 1989. at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Han Yang University. Among Z3 patients, male to female ratio was 11: 12 and Age of onset was ranged from 15 years-old to 52 years-old. Previous symptom duration from diagnosis until operation was ranged from 2 months to 96 months, and Mean duration was 28.74 months. The severity of disease was classified by Osserman`s classification preoperatively. In histopathology of thymus, Thymic hyperplasia 7 cases, Thymoma 7 cases, Invasive thymoma 3 cases, Within Normal Limit 5 cases, and Thymic Atrophy 1 case. Correlation between preoperative symptom duration and postoperative clinical course was statistically significant. The shorter of preoperative symptom duration, The better of postoperative clinical course. Grading of postoperative course was classified by Papatestas in 1975. Follow-up for postoperative course was ranged from 3 months to 7 year and 4 months, Cases of complete remission 1 year postoperative period were 9 cases and cases of Improvement were 8 cases, So totally 17 cases among 23 cases[73.91%] found good results.

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Clinical Experience of Open Heart Surgery - Report of 124 cases - (개심술 124예의 임상적 고찰)

  • Han, Gyun-In;Gwak, Yeong-Tae;Kim, Gi-Man
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.638-647
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    • 1989
  • From February 1985 to May 1989, 124 cases of cardiac surgery were performed under cardiopulmonary bypass at Dae-Jeon Eul-Ji General Hospital with the overall mortality of 8.06 We obtained relatively a higher mortality than other hospitals. The reasons are advanced disease status, inadequate preoperative diagnosis, lack of experience of surgeons in open heart surgery, lack of numbers and qualities of monitoring device and ventilator, and frequent migration of medico-surgical team. Most of the reasons are specific to the condition of the private hospital. The purpose of this article is going to make better preoperative and postoperative result by reviewing experienced cases with related articles.

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Primary Pulmonary Carcinosarcoma -A Case Report- (원발성 폐 암육종)

  • Song, Yo Jun;Lee, Nam Soo;Kim, Hyung Mook;Lee, Dale
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.157-160
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    • 1976
  • A 45-year-old male was admitted to Department of Thoracic Surgery, Korea University Hospital with the chief complaints of cough and high fever of two months duration. His chest roentgenogram revealed homogenous ill-defined increased density in right lower lung, and bronchogram showed the abrupt cut-off sign of the proximal portion of the right intermediate bronchus. Preoperative evaluation of this patient revealed no contraindication of the pulmonary surgery. So Radical Right pneumonectomy was performed under the preoperative impression of lung cancer. And post-operative course was uneventful. Pathologic examination of the resected lung revealed Carcinosarcoma without regional lymphnode metastasis.

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Surgical Treatment of Vascular Injuries (혈관손상에 관한 임상적 고찰)

  • 홍종완
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.984-989
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    • 1988
  • 2-D echocardiographic examination of the aortic root diameter was known to be useful in the selection of the size of the prosthetic valve. Valve-patient mismatch was occasionally a serious problem after valve replacement, especially in aortic valve disease. Preoperative knowledge of the patient`s valve annulus size is therefore of great importance in the surgical management of these patients. So the relationship between preoperative 2-D echocardiographic diameter of the annulus size and replaced prosthetic valve were evaluated. 13 patients were analyzed in this study. 2-D echocardiographic measurements of aortic annulus diameter, as determined from the parasternal long axis view and apical four chamber view, demonstrated a high correlation with actual prosthetic valve size implanted at surgery[r=0.86, p< 0.001, SEE=1.08].

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Surgical Treatment of Coronary Artery Occlusive Disease (관상동맥 협착증의 외과적 치험 -30례의 임상적 결과-)

  • 김병열
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.994-1000
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    • 1995
  • Thirty patients with ischemic heart disease underwent coronary artery bypass grafting [CABG from 1985 through 1994. There were 16 males and 14 females whose age ranged from 41 to 72 years old. Preoperative diagnoses were unstable angina in 13 of patients, stable angina in 8, postmyocardial infarction state in 7, and state of failed percutaneous transluminal coronary angioplasty [ PTCA in 2. The patterns of disease were single vessel involvement [ 17cases , double vessel involvement [ 7 cases , triple vessel involvement [ 3 cases , Lt main lesion including Lt. ostial lesion [ 3 cases . Saphenous vein grafts were used in 27/30 patients [ 90% , and internal mammary artery grafts were used in 6/30 patients [ 20% . The hospital mortality was 13.3% and all survivors were asymptomatic and improved over their preoperative status.

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The Effects of Tricuspid Annuloplasty on Funcional Tricuspid Regurgitation (기능적 삼첨판 폐쇄부전증 환자에서 판막륜 성형술의 효과)

  • 유경종
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.829-836
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    • 1995
  • Ninety-one adult patients underwent three different methods of annuloplasty and compared them by the amount of tricuspid regurgitation. Group I [n=17 is Kay method, Group II [n=46 is modified Kay method and Group III [n=28 is De Vega and modified De Vega method. Preoperative and postopeative size of the liver and its function, the cardiothoracic ratio, EKG and echocardiogram were analyzed. The follow up was done for all the patients [mean 20.0$\pm$ 8.5 months . The postoperative size of the liver, the postoperative cardiothoracic ratio and the postoperative systolic pressure of the right ventricle decreased significantly compared to preoperative size, ratio and pressure [p=0.0001, p=0.0001, p=0.0001 . But there were no differences between the groups. The results of annuloplasty revealed that tricuspid regurgitation improved postoperatively [p=0.0001 even though there was no statistically significant differences in relation to the methods of annuloplasty. The right ventricular systolic pressure and the amount of regurgitation decreased significantly during the postoperative period by performing 3 different methods of annuloplasty, although we could not find the differences between the three different methods.

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Clinical study of Pulmonary Sequestration (폐격리증에 대한 임상적 고찰)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.320-326
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    • 1985
  • Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

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Clinical Experiences of Multiple Organ Failure after Surgery for Acquired Cardiovascular Disease

  • 김병열
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.275-284
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    • 1990
  • A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

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A Surgical Experience of Infected Left Atrial Myxoma (감염된 좌심방 점액종 치험)

  • 노태훈
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.570-573
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    • 1987
  • A surgical operation on a patient with infected left atrial myxoma is presented. The patient was a 50-year-old woman who was admitted to the Kyung Hee Medical Center Hospital on March 7 1987 with complaints of high fever, cough and dyspnea that occurred a few days prior to admission. She, who no definite history of the previous cardiac-related problems was obtained from, had visited a dentist to have her eight teeth pulled out a few months prior to this admission. A preoperative 2-D echocardiogram revealed a left atrial tumor, strongly suggesting myxoma and two blood cultures drawn prior to surgery yielded streptococcus viridans. Under the preoperative impression of an infected left atrial myxoma, the tumor was removed through a biatrial approach after establishing CPB and cold cardioplegic. Pathologic examination of the tumor demonstrated a typical myxoma with bacterial colonies within. Postoperative course was uneventful and she was completely well at discharge from the hospital. To our best knowledge, this report is the first surgical experience of infected left atrial myxoma in the Korean literature.

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Correlation of Preoperative Pulmonary Function Testing and with Pulmonary Complication in Patients after Pneumonectomy (술전 폐기능과 전폐적출술후 폐합병증과의 연관성)

  • Bae, Byeong-U;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.26 no.8
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    • pp.620-626
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    • 1993
  • Determination of preoperatibe pulmonary function is crucial in avoiding complications from pulmonary resection, especially pneumonectomy. Postoperative morbidity and mortality were correlated with the preoperative results of five widely used tests of pulmonary function in 40 patients who underwent pneumonectomy for bronchiectasis, pulmonary tuberculosis, and carcinoma of the lung. Factors analyzed following operation included 30-day mortality, the incidence of arrhythmia, the frepuency of respiratory complications, and the number of individuals requiring prolonged mechanical ventilation. There were statistically significant differences[p<0.001]in mean values among FVC, FEV1, FEV1/FVC and MVV. But the difference of the FEF25-75% was not statistically significant.

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