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Growth of Right Ventricular Outflow Tract after "REV" Operation in Complex Congenital Heart Disease (복잡 심기형 환자에서 `REV`술후 우심실 출구 성장에 대한 고찰)

  • Lee, Jeong-Ryeol;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.15-25
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    • 1991
  • From February 1988 to December 1990, 42 patients underwent so called REV operation for pulmonary stenosis or atresia with or without anomalies of ventriculoarterial connection and truncus arteriosus. The principles of operative technique are mobilization of pulmonary arterial tree beyond the pericardial reflection, transection of pulmonary trunk between the pulmonary ventricle and pulmonary artery, suture of distal pulmonary arterial stump to the upper margin of Pulmonary ventriculotomy site with absorbable suture, and anterior patch with 0.625% glutaraldehyde fixed autologous pericardium with monocusp inside it. Age at operation ranged 3-156months [mean 41.8 month] with twelve of whom infants. Operative indications were pulmonary atresia, with ventricular septal defect[16], and pulmonary stenosis with double outlet right ventricle[8], with ventricular septal defect[16], with double outlet right ventricle[8], with complete transposition of the great arteries[8], with corrected transposition of the great arteries[6], with Fallot`s tetralogy[3], and truncus arteriosus[1]. There were six hospital deaths[14%] and no late death. Twenty-four of 36 survivals were followed up more than 12 months with good clinical results. Postoperative angiocardiogram was performed in fifteen patients. Hemodynamically, two patents had residual pressure gradients along the pulmonary outflow tract, one patient showed severe pulmonary regurgitation; morphologically, there were six significant stenosis of left pulmonary arterial tree, two of whom showed significant pressure gradients. Our present experience with REV operation suggests that this technique make it possible to perform anatomic repair in a wide variety of congenital anomalies of abnormal ventriculoarterial connection associated with pulmonary outflow tract obstruction without using the prosthetic material, even in infants, with relatively low mortality and morbidity.

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Management of Pediatric Patients Presenting with Acute Abdomen Accompanying Dilatation of the Common Bile Duct

  • Kim, Young A;Kim, Gyung Min;Chun, Peter;Hwang, Eun Ha;Mun, Sang Wook;Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.203-208
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    • 2018
  • Purpose: The aim of this study was to describe our treatment experiences with patients who had acute abdomen (AA) with common bile duct (CBD) dilatation. Methods: The treatment outcomes in children with AA and CBD dilatation were retrospectively reviewed. According to the shape of the intrahepatic bile ducts on ultrasonography (US), the origin of the pain was estimated as choledochal cyst (CC) complication or choledocholithiasis in normal CBD. Patients with complicated CC underwent surgery, and patients with choledocholithiasis in a normal appearing CBD underwent symptomatic treatment initially. Results: Of the 34 patients, 30 (88.2%) were female. The mean age of the patients was $6.4{\pm}4.9$ (range, 0.8-17) years. Seventeen (50.0%) patients had CBD stones and 17 (50.0%) did not. Surgical treatment was performed in 20 (58.8%) patients, 2 of whom underwent preoperative stone removal with endoscopic retrograde cholangiopancreatography and an operation. Conservative treatment was applied in 12 (35.3%) patients (8 with and 4 without stones), 1 of whom developed symptom relapse and underwent an operation. Among the 8 patients with CBD stones, 4 (4/17, 23.5%) had complete resolution of the stones and recovery of the CBD diameter after conservative treatment. US findings of patients with stone showed a fusiform or cylindrical shape of the CBD in 14 (82.4%) patients. Conclusion: The presence of stones in the distal CBD and the US features of CBD dilatation may be helpful to diagnose and treat the causes of biliary dilatation. Conservative treatment can be considered as initial therapy in patients with uncomplicated CBD dilatation with stone.

Open Communication About Reproductive Health Is Associated With Comprehensive HIV Knowledge and a Non-stigmatising Attitude Among Indonesian Youth: A Cross-sectional Study

  • Wirawan, Gede Benny Setia;Gustina, Ni Luh Zallila;Januraga, Pande Putu
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.4
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    • pp.342-350
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    • 2022
  • Objectives: Human immunodeficiency virus (HIV) prevention among youth seems under-prioritised compared to other key populations. HIV knowledge and stigma are important parts of HIV prevention. To inform HIV prevention among youths, this study quantitatively analysed the associations between open communication regarding sexuality and sexual health, comprehensive HIV knowledge, and non-stigmatising attitudes in Indonesia. Methods: This study used data from the Indonesian Demographic and Health Survey (IDHS) 2017. The analysis included unmarried men and women aged 15-25 years old. Comprehensive HIV knowledge and a stigmatising attitude were defined according to the IDHS 2017. Open communication about sexuality and sexual health was defined as the number of people with whom participants could openly discuss these topics in their direct network of friends, family, and service providers, with a scale ranging from 0 to a maximum of 7. Primary analysis used binomial logistic regression with weighting adjustments. Results: The final analysis included 22 864 respondents. Twenty-two percent of youth had no one in their direct network with whom to openly discuss sexual matters, only 14.1% had comprehensive HIV knowledge, and 85.9% showed stigmatising attitudes. Youth mostly discussed sex with their friends (55.2%), and were less likely to discuss it with family members, showing a predominant pattern of peer-to-peer communication. Multivariate analysis showed that having a larger network for communication about sexuality and sexual health was associated with more HIV knowledge and less stigmatising attitudes. Conclusions: Having more opportunities for open sex communication in one's direct social network is associated with more HIV knowledge and less stigmatising attitudes.

Traumatic Bilateral Diaphragmatic Ruptures in a 6-Year-Old Boy

  • Kim, Sung Jin;Kim, Hyuck;Lee, Jun Ho
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.19-23
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    • 2018
  • Traumatic diaphragmatic rupture is an unusual finding that may occur after blunt trauma. In addition, diaphragmatic rupture occurring bilaterally is extremely rare. We experienced a 6-year-old boy with bilateral diaphragmatic rupture, whom survived after surgical treatment by open thoracotomy but, complicated with spinal cord injury discovered after surgery.

Pain Management for Cancer Patients (암 환자를 위한 통증 관리)

  • Hwang, Kyoo-Hyun
    • The Korean Journal of Pain
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    • v.3 no.1
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    • pp.11-14
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    • 1990
  • Thirty-two cancer patients were treated with various pain control methods. In those who had localized pain or more than 1 year life expectancy. The author preferred neurolytic blockade for whom had localized pain or had more than 1 year life-expectancy to epidural or intrathecal narcotics. The latter methods were saved as a last resort. Effective pain relief was achieved in over 80% of those treated. There were no serious complications. Of the 12 epidural or intrathecally implanted catheter with subcutaneous tunneling cases, successful pain management was possible throughout the remainder of life which was from 1 week to 6 months.

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A Conditional Unrelated Question Model with Quantitative Attribute

  • Lee, Gi Sung;Hong, Ki Hak
    • Communications for Statistical Applications and Methods
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    • v.8 no.3
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    • pp.753-765
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    • 2001
  • We suggest a quantitative conditional unrelated question model that can be used in obtaining more sensitive information. For whom say "yes" about the less 7han sensitive question .B we ask only about the more sensitive variable X. We extend our model to two sample case when there is no information about the true mean of the unrelated variable Y. Finally we compare the efficiency of our model with that of Greenberg et al.′s.

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Postpneumonectomy Esophagopleural Fistula: Muscle Flap Transposition for Closure (우측폐 전절제술후 발생한 식도늑막루의 수술 치험 : 1례 보고)

  • 이형교
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1275-1279
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    • 1990
  • Esophagopleural fistula is a rare complication that should be suspected in all patients with recurrent empyema following pneumonectomy and in whom a bronchopleural fistula can be excluded. In late postpneumonectomy esophagopleural fistula, diagnosis is difficult due to its rarity and no specific symptom and sign, but we have experienced a man who had suffered dysphagia and odynophagia. In surgical treatment of late postpneumonectomy esophageal fistula, closure of empyema space is of prime importance. We have adopted a type of latissimus dorsi muscle and serratus anterior muscle flap transposition We present here this technique and result obtained in patient with late postpneumonectomy esophagopleural fistula.

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A New Technique of Sternal Closure with Plastic Plates (Plastic plates 를 이용한 흉골 봉합술 - 치험 1례 -)

  • 박철현
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.820-824
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    • 1990
  • A very early and effective technique of sternal closure by plastic plates was successfully applied to a 7-months-old infant of tetralogy of Fallot in whom the standard closure of sternum was not possible due to massive generalized edema after cardiopulmonary bypass for total correction. This technique provides not only solid but also permanent closure of the sternum so that any early reoperation for closure of sternum and its accompanying risk of infection in many other known methods can be avoided.

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Torsade de Pointes Associated with Hypomagnesemia after Open Heart Surgery - A Report of 2 Cases - (개심술후 저마그네슘증에 동반된 Torsade de Pointes;치험 2례 보고)

  • 노환규
    • Journal of Chest Surgery
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    • v.25 no.2
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    • pp.188-193
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    • 1992
  • Life-threatening cardiac arrhythmia is a frequent complication of open heart surgery. There are many causes of postoperative cardiac arrhythmias. Electrolyte imbalance such as hypokalemia and acidemia are major causes of ventricular arrhythmias. Infrequently, however, antiarrhythmic agents and /or hypomagnesemia induce[s] a ventricular arrhythmia such as "torsade de pointes" by increasing the repolarization time of myocardium, Recently, we have experienced two cases of "Torsade de pointes" associated with hyp-omagnesemia after replacement of mitral valve and one of whom after use of procainamide. Intravenous infusion of magnesium immediately and successfully abolished the torsade de pointes in both cases.intes in both cases.

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Cor Triatriatum Associated with Total Anomalous Pulmonary Venous Connection: A Rare but Plausible Combination

  • Lee, Jun Oh;Park, Chun Soo
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.143-145
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    • 2021
  • In a newborn in whom cor triatriatum was missed on echocardiography, infracardiac total anomalous pulmonary venous connection was successfully repaired with the aid of cardiac computed tomography (CT). In rare combinations, as in this case, an accurate diagnosis prior to surgery, which is of vital importance for successful repair, can be made through a high index of suspicion and the use of a supplemental imaging modality such as CT.