• Proceedings of the KOR-BRONCHOESO Conference
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• 2005.04a
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• pp.22.1-22.1
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• 2005

• Journal of Chest Surgery
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• v.3 no.2
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• pp.153-157
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• 1970

The problembs of mitral reste'1osis following primary mitral comissurotomy for mitral stenosis have been increased gradually, and also its incidence of mitral restenosis has showed the increasing time by time. We report 3 cases operation.l of mitral restenosis among several cases which have followed primary operatioa for 254 cases of mitral stenosis from Jan. 1959 to Dec. 1969. at the department of thoracic and cardiovascuar surgery, Natioaal Medical Center, with a review of literatures.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.221-227
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• 1986

Ventricular septal defect is most common congenital cardiac anomaly in Korea and worldwide. And its clinical spectrum is well known. The anatomic classification had been undertaken by several authors, but recently Dr. Soto and Anderson's classification is widely used instead of Dr. Kirklin's it. From April. 1984 to December 1986, 99 cases of ventricular septal defects had been taken surgical repair under direct vision using conventional cardiopulmonary bypass technique at Yeungnam university hospital. The clinical spectrum was similar to other hospital, and the postoperative mortality was 2%, The most common associated anomaly was patent foramen ovale, and the most common postoperative complication was incomplete or complete right bundle branch block. The rank of defects was as followings: 45 perimembranous inlet type, 21 doubly commited subarterial type, 17, perimembranous trabecular type, and 16 perimembranous outlet type. There was no muscular and mixed type.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.263-270
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• 1996

Twenty two patients underwent total anatomic correction of complete atrioventricular septal defect associated with other cardiac anomalies between July 1986 and December 1994. Age ranged from 6 months to 11 years(mean 49.6 $\pm$ 35.8 months), and they were composed of 7 males and 15 females. Combined major cardiac anomalies were tetralogy of Fallot(TOF) in 11 cases, double outlet of right ventricle (DORV) in 6 ca es, and transposition of great arteries (TGA) in 5 cases. Down's syndrome was associated in 5 patients with TOF and 1 patient with DORV. They were classified as Rastelli type A in 3 patients, B in 2 patients, and C in 17 patients. Modified Blalock-Taussig shunt was performed.in 5 patients and Waterston shunt in 1 patient as a palliative procedure. There were 7 perioperative deaths(31.8%) and the causes were pump weaning failure, low cardiac output, acute renal failure, persistant pulmonary hypertension and hypertensive crisis, and sepsis. Reoperations were performed in 4 cases to repair atrioventricular valvular regurgitation or to relieve the right ventricular outflow tract (RVOT) or pulmonary arterial stenosis. One late death was due to aspiration pneumonia. Second reoperation was necessary for progressive worsening of left atrioventricular regurgitation and RVOT stenosis in one patient. Fourteen survived patients were followed up for a mean of 66.0 $\pm$ 26.7months and all of them w re NYHA functional class I or II.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.512-517
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• 2005

Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.215-225
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• 2001

Background: There are many evidences that inflammation is an important determinant of the development of atherosclerosis and one of the systemic markers of inflammation, C-reactive protein(CRP), is associated with extent of coronary artery disease and risk of coronary events. We assessed the time response of CRP response after coronary angioplasty and it's influence on the clinical restenosis in angina patients. Materials and Methods: Patients included 36 angina patients undergoing single vessel angioplasty. Levels of CRP were measured before and 12, 24, 48, and 72 hours after angioplasty. Clinical restenosis was assessed at 6 months after procedure. Results: Baseline CRP level was $0.30{\pm}0.01$ mg/dL in stable and $0.46{\pm}0.28$ mg/dL in unstable angina patients(p<0.05). After angioplasty, CRP level was increased with peak at 24 hour and persisted to 72 hours after angioplasty. At 24 hour after angioplasty, the magnitude of CRP change was $0.32{\pm}0.31$ mg/dL in stable and $0.79{\pm}0.73$ mg/dL in unstable angina patient(p<0.05). The change of CRP level was not associated with troponin-T after angioplasty. In unstable angina patients, clinical restenosis was developed in 8% of patients with low baseline CRP levels and in 50% of those with high baseline CRP levels more than 0.6 mg/dL(p<0.05). Conclusion: In unstable angina patients, inflammatory response is more increased than stable angina patients, and increased inflammatory response effects on the restenosis after coronary angioplasty.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.1-14
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• 1983

The most common cause of the decannulation difficulty is the trauma. This may be accidental, iatrogenic such as prolonged intubation, high tracheostomy, secondary infection, formation of granulation tissue, improper use of cannula and wide resection of anterior tracheal wall. Another common cause is psychologic dependency. Treatments may be categorized into dilatation with or without injection of steroid, dilatation and prolonged stent, luminal augmentation and resection of the stenosis with primary reanastomosis. Recently authors experienced a case of the decannulation difficulty in a 2 - year - old which was developed after tracheostomy for the removal of bronchial foreign body and was treated with a silicon T -tube stent with good result.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.444-447
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• 2003

Sleeve pneumonectomy can be a method of treatment in a selected patient with bronchogenic carcinoma involving carina. A 64 years old male with a history of mitral valve replacement via midsternotomy 13 years ago and resection of papilloma of the vocal cord 2 years ago. The patient was admitted due to blood-tinged sputum. Bronchoscopy and computerized tomogram of the chest revealed 3.5 cm mass at lower margin of the trachea and totally obstructing the left main bronchus. A biopsy revealed squamous cell carcinoma. He underwent left sleeve pneumonectomy through sequential bilateral thoracotomy without cardiopulmonary bypass, and the pathologic stage was T4N0M0 stage IIIB. The patient is being followed through the outpatient clinic in good general condition.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.610-614
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• 1998

The first heart-lung transplantation in Korea was successfully performed. The recipient was a 11 year old girl with pulmonary atresia with intact ventricular septum. She had been catheterized at the ages of 4 months, 3 years, 7 years and 10 years, which revealed that neither Fontan nor biventricular repair was feasible. The donor was a traffic accident victim, a 9 year-old boy with the same blood type. The donor was pronounced dead according to the guidelines of the Korean Medical Association's Brain Death Committee. The operation was performed on April 20, 1997. The native heart-lung block was explanted segmentally and donor one was placed above the phrenic nerve using the Arizona technique. After the tracheal anastomosis with single continuous 4-0 prolene, both vena cavae were anastomosed, followed by aortic anastomosis. The graft ischemic time was 145 minutes. The postoperative course was complicated by fever and tracheal stenosis at the anastomosis site. The fever was controlled by anti-tuberculous medications and the tracheal stenosis was relieved by stent(Palmaz 8 mm, 30 mm in length) placement on POD #71. The patient is doing well and is very active in her 7th postoperative month.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.38-43
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• 2008

Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.