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Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer (근침윤성 방광암 환자의 방광 보존적 치료 결과)

  • Yu, Jeong-Il;Oh, Dong-Ryol;Huh, Seung-Jae;Choi, Han-Yong;Lee, Hyon-Moo;Jeon, Seong-Soo;Yim, Ho-Young;Kim, Won-Suk;Lim, Do-Hoon;Ahn, Yong-Chan;Park, Won
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.70-78
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    • 2007
  • [ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.

A Phase I/II Trial of $DCVac/IR^{(R)}$ Dendritic Cell Immunotherapy Combined with Irradiation in Cases of Refractory Colorectal Cancer with Multiple Liver Metastases (기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험)

  • Choi, Young-Min;Lee, Hyung-Sik;Kwon, Hyuk-Chan;Han, Sang-Young;Choi, Jong-Cheol;Chung, Ju-Seop;Kim, Chang-Won;Kim, Dong-Won;Kang, Chi-Duk
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.104-112
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    • 2008
  • Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

Comparative Analysis of Patterns of Care Study of Radiotherapy for Esophageal Cancer among Three Countries: South Korea, Japan and the United States (한국, 미국, 일본의 식도암 방사선 치료에 대한 PCS($1998{\sim}1999$) 결과의 비교 분석)

  • Hur, Won-Joo;Choi, Young-Min;Kim, Jeung-Kee;Lee, Hyung-Sik;Choi, Seok-Reyol;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.83-90
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    • 2008
  • Purpose: For the first time, a nationwide survey of the Patterns of Care Study(PCS) for the various radiotherapy treatments of esophageal cancer was carried out in South Korea. In order to observe the different parameters, as well as offer a solid cooperative system, we compared the Korean results with those observed in the United States(US) and Japan. Materials and Methods: Two hundreds forty-six esophageal cancer patients from 21 institutions were enrolled in the South Korean study. The patients received radiation theraphy(RT) from 1998 to 1999. In order to compare these results with those from the United States, a published study by Suntharalingam, which included 414 patients[treated by Radiotherapy(RT)] from 59 institutions between 1996 and 1999 was chosen. In order to compare the South Korean with the Japanese data, we choose two different studies. The results published by Gomi were selected as the surgery group, in which 220 esophageal cancer patients were analyzed from 76 facilities. The patients underwent surgery and received RT with or without chemotherapy between 1998 and 2001. The non-surgery group originated from a study by Murakami, in which 385 patients were treated either by RT alone or RT with chemotherapy, but no surgery, between 1999 and 2001. Results: The median age of enrolled patients was highest in the Japanese non-surgery group(71 years old). The gender ratio was approximately 9:1(male:female) in both the Korean and Japanese studies, whereas females made up 23.1% of the study population in the US study. Adenocarcinoma outnumbered squamous cell carcinoma in the US study, whereas squamous cell carcinoma was more prevalent both the Korean and Japanese studies(Korea 96.3%, Japan 98%). An esophagogram, endoscopy, and chest CT scan were the main modalities of diagnostic evaluation used in all three countries. The US and Japan used the abdominal CT scan more frequently than the abdominal ultrasonography. Radiotherapy alone treatment was most rarely used in the US study(9.5%), compared to the Korean(23.2%) and Japanese(39%) studies. The combination of the three modalities(Surgery+RT+Chemotherapy) was performed least often in Korea(11.8%) compared to the Japanese(49.5%) and US(32.8%) studies. Chemotherapy(89%) and chemotherapy with concurrent chemoradiotherapy(97%) was most frequently used in the US study. Fluorouracil(5-FU) and Cisplatin were the most preferred drug treatments used in all three countries. The median radiation dose was 50.4 Gy in the US study, as compared to 55.8 Gy in the Korean study regardless of whether an operation was performed. However, in Japan, different median doses were delivered for the surgery(48 Gy) and non-surgery groups(60 Gy). Conclusion: Although some aspects of the evaluation of esophageal cancer and its various treatment modalities were heterogeneous among the three countries surveyed, we found no remarkable differences in the RT dose or technique, which includes the number of portals and energy beams.

Effect of Air Circulation Velocity on the Rate of Lumber Drying in a Small Compartment Wood Drying Kiln (소형 목재인공건조실에 있어서 공기순환속도가 목재건조율에 미치는 영향)

  • Chung, Byung-Jae
    • Journal of the Korean Wood Science and Technology
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    • v.2 no.2
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    • pp.5-7
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    • 1974
  • 1. This study indicates that above the fiber saturation point the drying rate can be increased with increasing the velocity of the air circutation, i.e., the drying rate of sample boards is proportional to the air velocity, but below the fiber saturation point, the effect of the velocity of air circulation is very low as shown in Figs. 1 and 2. 2. Under the controlled temperature and humidity in the kiln, the more the sample boards have moisture, the higher drying rate of it can be obtained. In other words, this means that even though in the case of drying various moisture content of wood, at the final drying stage, approximately the same percentage of moisture content of wood can be secured by employing the higher velocity of air circulation. 3. This study shows that the rate of drying in kiln changes distinctly at the fiber saturation point, i, e., above the fiber saturation point, the drying curve shows concave aginst the X axsis, but below the fiber saturation point, in the range from 30 percent of moisture content to 20 percent of moisture content, the curve shows convex as shown in Fig. 3. As the drying progresses, however, the drying curve shows concave again below 20 percent of moisture content. This means that inflection point of drying curve may be located clearly at the fiber saturation point, i.e., 30 percent of moisture content. As mentioned above, the 30 percent of moisture content of wood at which the inflectional point appears can be recognized as a critical point, i. e., the fiber saturation point at which all free water was removed from wood. The existence of inflectional point indicates that the evaporation of hygroscopic water in a cell wall is more difficult than the evaporation of free water in a cell cavity and the minor space of cell wall. The convex curve in the range of moisture content from 30 percent to 20 percent means that the evaporation of capillary condensed water has a tendency of the same rates of drying approximately, but as approaching to the 20 percent of moisture, the transfusion of moisture from wood becomes difficult because of having less moisture in cell wall. Below 20 percent of moisture content, the drying curve shows concave again, which means that it is difficult to remove the moisture located nearer to the surface of cellulose molecules and the surface bound water. These relations were revealed in Fig. 4. In comparison AC curve which does not have the two inflection points with BD curve which has two inflection points, i.e., Band D, they are mentioned already, by existence of the inflection points, the curve BD shows that the change of drying rate in the interval from 20 percent of moisture content to 30 percent of moisture content is not greater than in the case of the curve AC in the same interval. At the inflection point of 30 percent of moisture content, it can be noticed that the changing of the drying rate is very conspicuous. This phenomenon also can be recognized, as it is noticed by the Fig. 3, the drying rate from green to 30 percent of moisture content is very great. But the inclination of the curve is very slow from 30 percent of moisture content to 20 percent of moisture content, i.e., the inclination of the curve becomes almost horizontal lines. Acknowledgments Gratitude is expressed to Fred E. Dickinson, Professor of 'Wood Technology, School of Natural Resources, University of Michigan, USA for his suggestion to carry out this study.

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The Correction Factor of Sensitivity in Gamma Camera - Based on Whole Body Bone Scan Image - (감마카메라의 Sensitivity 보정 Factor에 관한 연구 - 전신 뼈 영상을 중심으로 -)

  • Jung, Eun-Mi;Jung, Woo-Young;Ryu, Jae-Kwang;Kim, Dong-Seok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.208-213
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    • 2008
  • Purpose: Generally a whole body bone scan has been known as one of the most frequently executed exams in the nuclear medicine fields. Asan medical center, usually use various gamma camera systems - manufactured by PHILIPS (PRECEDENCE, BRIGHTVIEW), SIEMENS (ECAM, ECAM signature, ECAM plus, SYMBIA T2), GE (INFINIA) - to execute whole body scan. But, as we know, each camera's sensitivity is not same so it is hard to consistent diagnosis of patients. So our purpose is when we execute whole body bone scans, we exclude uncontrollable factors and try to correct controllable factors such as inherent sensitivity of gamma camera. In this study, we're going to measure each gamma camera's sensitivity and study about reasonable correction factors of whole body bone scan to follow up patient's condition using different gamma cameras. Materials and Methods: We used the $^{99m}Tc$ flood phantom, it recommend by IAEA recommendation based on general counts rate of a whole body scan and measured counts rates by the use of various gamma cameras - PRECEDENCE, BRIGHTVIEW, ECAM, ECAM signature, ECAM plus, IFINIA - in Asan medical center nuclear medicine department. For measuring sensitivity, all gamma camera equipped LEHR collimator (Low Energy High Resolution multi parallel Collimator) and the $^{99m}Tc$ gamma spectrum was adjusted around 15% window level, the photo peak was set to 140-kev and acquirded for 60 sec and 120 sec in all gamma cameras. In order to verify whether can apply calculated correction factors to whole body bone scan or not, we actually conducted the whole body bone scan to 27 patients and we compared it analyzed that results. Results: After experimenting using $^{99m}Tc$ flood phantom, sensitivity of ECAM plus was highest and other sensitivity order of all gamma camera is ECAM signature, SYMBIA T2, ECAM, BRIGHTVIEW, IFINIA, PRECEDENCE. And yield sensitivity correction factor show each gamma camera's relative sensitivity ratio by yielded based on ECAM's sensitivity. (ECAM plus 1.07, ECAM signature 1.05, SYMBIA T2 1.03, ECAM 1.00, BRIGHTVIEW 0.90, INFINIA 0.83, PRECEDENCE 0.72) When analyzing the correction factor yielded by $^{99m}Tc$ experiment and another correction factor yielded by whole body bone scan, it shows statistically insignificant value (p<0.05) in whole body bone scan diagnosis. Conclusion: In diagnosing the bone metastasis of patients undergoing cancer, whole body bone scan has been conducted as follow up tests due to its good points (high sensitivity, non invasive, easily conducted). But as a follow up study, it's hard to perform whole body bone scan continuously using same gamma camera. If we use same gamma camera to patients, we have to consider effectiveness of equipment's change by time elapsed. So we expect that applying sensitivity correction factor to patients who tested whole body bone scan regularly will add consistence in diagnosis of patients.

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Effects of Applying Livestock Manure on Productivity and Organic Stock Carrying Capacity of Summer Forage Crops (가축분뇨시용이 하계사료작물의 생산성 및 유기가축 사육능력에 미치는 영향)

  • Jo, Ik-Hwan;HwangBo, Soon;Lee, Ju-Sam
    • Korean Journal of Organic Agriculture
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    • v.16 no.4
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    • pp.421-434
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    • 2008
  • This study was carried out to estimate the selection of appropriate forage crops, proper application levels of livestock manure, and carrying capacity per unit area for organic livestock, as influenced by livestock manure application levels compared with chemical fertilizer to corn and sorghum $\times$ sorghum hybrid, in order to produce organic forages by utilizing livestock manure. For both corns and sorghum $\times$ sorghum hybrids, no fertilizer plots had significantly (p<0.05) lower annual dry matter (DM), crude protein (CP) and total digestible nutrients (TDN) yields than those of other plots, whereas the N+P+K plots ranked the highest yields, followed by 150% cattle manure plots and 100% cattle manure plots. Dry matter, CP and TDN yields of cattle manure plots were significantly (p<0.05) higher than those of no fertilizer and P+K plots. In applying cattle manure, the yields of cattle slurry plots tended to be a little higher than those of composted cattle manure plots. Assuming that corns and sorghum $\times$ sorghum hybrids produced from this trial were fed at 70% level to 450kg of Hanwoo heifer with 400g of average daily gain, livestock carrying capacity (head/year/ha) ranked the highest in N+P+K plots of the case of corns (mean 6.7 heads), followed by 150% cattle slurry plots (mean 5.6 heads), 150% composted cattle manure plots (mean 4.8 heads), 100% cattle slurry plots (mean 4.4 heads), 100% composted cattle manure plots (mean 4.3 heads), P+K plots (mean 4.1 heads), and no fertilizer plots (mean 3.1 heads). Meanwhile, in case of sorghum $\times$ sorghum hybrids, N+P+K plots (mean 5.7 heads) ranked the highest carrying capacity, followed by $100{\sim}150%$ cattle slurry plots (mean $4.8{\sim}5.2$ heads), 150% composted cattle manure plots (mean 4.7 heads), 100 % composted cattle manure plots (mean 4.3 heads), P+K plots (mean 3.8 heads), and no fertilizer plots (mean 3.4 heads). The results indicated that replacing chemical fertilizer by livestock manure application to cultivation soil for forage crops could enhance not only DM and TDN yields, but also organic stock carrying capacity. In conclusion, it was conceived that organic forage production by reutilizing livestock manure might contribute to reduced environmental pollution and the production of environment friendly agricultural products through resources recycling.

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Studies on the Organic Tiers Contained Paddy Soils in Honam Area -I. The Characteristcs and Formation of Organic Tiers Contained Paddy Soils (유기질토시(有機質土尸)을 함유(含有)한 호남지역(湖南地域) 답토양(畓土壤)에 관(關)한 연구(硏究) -I. 유기질토시함유(有機質土尸含有) 답토양(畓土壤)의 특성(特性) 및 생성(生成))

  • Yoo, Chul-Hyun;Kim, Eung-Bog;Cho, Guk-Hyun;Kim, Han-Myoung;Yoo, Sug-Jong;Park, Keon-Ho;Bae, Sung-Ho;Um, Ki-Tae
    • Korean Journal of Soil Science and Fertilizer
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    • v.18 no.3
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    • pp.265-275
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    • 1985
  • Present studies were carried out to investigate the distribution and formation of organic tiers contained paddy soils in Honam area characteristics to give basic informations on the effective utilization, management and improvement of the soils. The results obtained were summarized as follows; 1. The extent of organic tiers contained paddy soils in Honam area were 6.538㏊ and the amount of peat deposits were presumed about 2.41 million M/T. 2. Out of the total extent of the organic tiers contained paddy soils, about 97.6% was distributed in Honam plains (water-sheds of Mangyeong-Dongjin river), while about 1.5% in the Naju plains (water-sheds of Yeongsan river), and 0.9% in the Wando and Yeocheon areas. 3. The period of peat formation was presumed to be about the early of Seung Moon period (B.C. 4,250), and the Gongdeog series and the Bongnam series were formed in the bog conditions close to the valley mouth of near rolling and hill with small steram channels, and the Gimje series was formed in the out-skirts plains of the Gongdeog and Bongnam soils. 4. In the casue of peat formation, it was presumed to be the Gimje series that accumulated the fibrous peat out of the autochthonous peat such as reeds and grasses etc, to be the Gongdeog and Bongnam series that accumulated the autochtonous peat and the xylem and fibrous peat out of first allochthonous peat. 5. In the Organic horizons of these soils, the range of muck and peat horizons were in 62-68cm and 68-137cm of soil profile in the Gongdeog series, 52-84cm and 84-113cm in the Bongnam series respectively, one of muck horizon was in 46-71cm in the Gimje series. 6. The marks of soil horizons of the soils were expressed that the lower soils than the horizon of muck and peat were formed Cg, Aag for the muck horizon, 0 for the peat horizon, 0 of peat horizon were distingushed with Oag and Oig according to Organic forms. 7. The depthe occurred the muck and peat horizons were positively correlated with the width of local in the Gongdeog series ($r=0.881^{**}$, $r=0.827^{**}$), but not in the Bongnam series and Gimje series.

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Biological control of mushroom flies using the predatory mite Hypoaspis aculeifer in a shiitake cultivation (원목 표고에서 아큐레이퍼응애를 이용한 버섯파리류의 생물학적 방제)

  • Kim, Hyeong Hwan;Kim, Dong Hwan;Yang, Chang Yeol;Kwon, Sun Jung;Jeon, Sung Wook;Song, Jin Sun;Cho, Myoung Rae;Lee, Chan Jung;Cheong, Jong Chun
    • Journal of Mushroom
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    • v.11 no.4
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    • pp.230-239
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    • 2013
  • The major species of fungus gnats which caused the severe damage in shiitake farm were identified as a Bradysia difformis, B. alpicola, and Camtomyia cortocalis on oak log beds cultivation. The B. difformis occurred early in the middle of March while B. alpicola and C. cortocalis appeared since the beginning of May. The occurrence rate for adults of B. difformis showed highly at the end of July (11.9~1,774.2 in dong-myeon and 0.4~2,583.3 in pungse-myeon) in 2012 and mid-June (10.7~4,650 in dong-myeon and 36.8~4740 in pungse-myeon) in 2013. The counting numbers on the traps for B. alpicola reached highest peak in the middle of June (2.1~63.2 in dong-myeon and 1.0~21.7 in pungse-myeon) and the end of May (0.8~163.7 in dong-myeon and 0.5~280.5 in pungse-myeon) in 2012 and 2013, respectively. The number of C. cortocalis showed high record in the middle of May in 2012 (0.6~4.7) and in the middle of June (2.1~17.3) in 2013 in dong-myeon whereas showed the peaks in the middle of May (0.6~4.7) in 2012 and in the late of May (1.3~17.6) in 2013 in pungse-myeon. The fruiting bodies of shiitake mushroom by fungus gnats were severely damaged from mid-June to late-July and the damage rate were 0.625.5% (2012) and 0.7~30.5% (2013) in dong-myeon and 1.5%~21.6% (2012) and 1.9~36.8%(2012) in pungse-myeon. To investigate the control effect for fungus gnats by Hypoaspis aculeifer, H. aculeifer (30 mixutre of nymph and adult per $m^2$) were treated to oak log beds shiitake cultivation for six times (May 2 and 28, June 25, July 10 and 25 and August 28). The occurrence rate of adults and damage rate of fruiting bodies of 3 major species reduced 79.3% (adult numbers) and 74.8% (fruiting bodies) in dong-myeon and 64.1% (adult numbers) and 65.5% (fruiting bodies) in pungse-myeon, respectively, compared to non-treatment. Accordingly, H. aculeifer effectively controlled the fungus gnats on shiitake mushroom and can be used as good control agent.

Helicobacter pylori Infection in Children with Recurrent Abdominal Pain (소아에서 만성 반복성 복통(Recurrent Abdominal Pain)과 Helicobacter pylori 감염과의 연관성에 대한 연구)

  • Na, So Young;Seo, Jeong Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.1-11
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    • 2005
  • Purpose: The aim of this study was to evaluate the relationship between H. pylori infection and recurrent abdominal pain (RAP) in children and to evaluate the effects of eradication therapy on RAP. Methods: From January 1998 to January 2005, 166 children with RAP (61 male, 105 female) aged $10.0{\pm}3.3$ years were included. Upper gastrointestinal endoscopies were performed for all the patients. All H. pylori infected children (n=70) received the eradication therapy and were divided into two groups: Group Ia (n=52); eradicated, Group Ib (n=18); non-eradicated. H. pylori-negative children (n=96) were divided into three groups according to the medication: Group IIa (n=67); no medication, Group IIb (n=13); acid-suppressant, Group IIc (n=16); both acid-suppressant and antibiotics. Questionnaire for symptoms were asked at the first, 6th, 12th, 24th, and 36th months following the treatment (grade 0; completely resolved, grade 1; definitely improved, but there are occasional episodes of mild abdominal pain, grade 2; no change in the frequency and intensity of abdominal pain). Results: In about 90% of H. pylori positive children, RAP improved in the both H. pylori-eradicated and non-eradicated children in a follow-up survey. In about 75% of H. pylori-negative children, RAP also improved among in the three groups of patients regardless of medication. Conclusion: These results suggest that there was no correlations between improvement of RAP and eradication of H. pylori, and between improvement of RAP and medication. Consequently the reassurance that the children with RAP have no serious organic cause was important to improvement of RAP.

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Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients (승모판폐쇄부전증를 가진 소아 환자에서 승모판성형술의 임상적 고찰)

  • Sim, Hyung-Tae;Yun, Tae-Jin;Park, Jeong-Jun;Jung, Sung-Ho;Uhm, Ju-Yeon;Jhang, Won-Kyoung;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.536-545
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    • 2007
  • Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years, The mean age was $5.3{\pm}5.3$ years and the mean body weight was $20,0{\pm}16.3\;kg$. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were $93.3{\pm}4.6%$ and $76.1{\pm}8.2%$, respectively. The 5-year freedom from mitral valve replacement rate was $83.6{\pm}6.7%$. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.