During the period from 1958 to July 31, 1980, there were 1764 Cardiovascular Surgical cases consisting of 1166 congenital and 598 acquired lesions in the Department of Cardiothoracic Surgery, Seoul National University Hospital. For 1764 cases 1162 open heart surgery and 602 conventional operations were performed. Among 1166, congenital lesions 266 adult cases were found. Adult cases occupy 15.1% of the total cases consisting of 24.5% of acyanotic and 19.9% of cyanotic group. Over all operative mortality of adult cases was 6.8% compared with 12.4% of total cases. Left over congenital cardiovascular anomalies in Korea can be safely operated at the present time. The oldest operated patient among adult congenital cardiovascular anomalies was 57 years old female atrial septal defect case. For 1162 cases open heart surgery bubble oxygenators were utilized except 2 membrane oxygenators. Various kinds of bubble oxygenators have been used but recently Shiley**** oxygenators are being used exclusively with satisfactory results.
Cytologlc evaluation of cerebrospinal fluid(CSF) is an effective mean for diagnosing many disorders involving the central nervous systems(CNS). One of the most important reasons for cytologic examination of CSF is to detect metastatic or primary neoplasms of the CNS. We did a retrospective study of 1,438 CSF specimens obtained between 1992 and 1996. A total of 1,205 adult and 233 pediatric CSF specimens from 947 patients were accessed at the Department of Pathology of Seoul National University Hospital and Children's Hospital, respectively. Among 1,438 CSF cytology specimens, 169 cases(11.8%, 77 patients) including 135 adult cases(59 patients) and 34 pediatric cases(18 patients) were positive for malignant cells. Diagnoses included 50 metastatic carcinomas(adult, 60; pediatric, 0); 46 malignant lymphomas(adult, 44; pediatric, 2); 21 leukemias(adult, 20; pediatric, 1); 4 retinoblastomas(adult, 0; pediatric 4); 2 rhabdomyosarcomas(adult, 0; pediatric, 2); 1 multiple myeloma(adult, 1; pediatric, 0), and 35 primary CNS neoplasms(adult, 10; pediatric, 25). The most commonly identified metastatic carcinomas in adults were adenocarcinoma. Their primary sites were the lung, gastrointestinal tract, and breast in order of frequency. The most common primary CNS neoplasm in children was medulloblastoma.
Patent ductus arteriosus in adult is frequently complicated with aneurysm, calcification and pulmonary hypertension. Therefore, surgical treatment of patent ductus arteriosus in adult has some differences from that of infants and children. We have experienced 25 cases of adult patent ductus arteriosus from July 1983 to December 1994. Mean age of the patients was 26.6 years[16-59 years . There were 12 males and 13 females. Exertional dyspnea was the most frequent clinical manifestation. Pulmonary hypertension was present in eight patients. Ligation was done in 20 cases and surgery using cardiopulmonary bypass was done in 5 cases. There was one hospital death, which had a 5x5cm sized main pulmonary artery aneurysm and was operated under cardiopulmonary bypass. Recanalization occured in one patient who received Teflon-felt supported ligation. Although one case of recannalization after ligation was present, we believed the fact that ligation was safe and simple method of operation in adult patent ductus arteriosus without calcification and aneurysm.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.15
no.1
/
pp.140-150
/
2002
Introduction: Atopic dermatitis is chronic eczematous dermatosis which is related strongly to a family history of atopic disease and hereditary disposition. Its threshold of itching is low so that severe itching occurs and causes secondary eczema. Adult atopic dermatitis has mostly severe symptoms and progresses to chronic relapsing. Objective: The purpose of this study was to estimate the efficacy of oriental medical treatment and management on chronic adult atopic dermatitis. Subject: We studied 3 patients who visited Dongguk University Gangnam Oriental Hospital Dept. of Dermatol. with chronic adult atopic dermatitis from August 2001 to April 2002 and were observed for over 4 months. Methods: We treated them with herb-medication, acupuncture, negative therapy, aroma therapy, full spectrum visible ray therapy(by carbon arc) and external application(Jaun-go). We used the SCORAD index to assess the severity of atopic dermatitis. Results: There were 3 patients with chronic adult atopic dermatitis we could check for over 4 months by clinical scoring using the SCORAD system. 1. The grades of the severity of atopic dermatitis were lower only by the oriental medical treatments and management. 2. Intensities of relapse cases were lower then before the oriental medical treatments. 3. The secondary treatment term for relapse cases was shorter then the first treatment term after oriental remedies were used. Conclusion: Considering the above results, more study is needed on the chronic relapse cases with adult atopic dermatitis, the factors of increasing seventy of adult atopic dermatitis, the prognostic factors of adult atopic dermatitis, and the clinical interchange of chronic adult atopic dermatitis between oriental medicine and western medicine.
Between 1973 and 1981 a total of 38 patients with a adult Patent Ductus Arteriosus, resulting from a congenital heart disease. There were 10 males and 28 females and most were in their twenties. In 21 cases, typical Patent Ductus Arteriosus without pulmonary hypertension and in 17, atypical Patent Ductus Arteriosus with pulmonary hypertension were noted. Methods of surgical treatment were division, double ligation, triple ligation, or wrapping with Teflon felt and ligation. The number of patients for each surgical treatment were 23 cases with double ligation, 4 cases with triple ligation, 3 cases of wrapping with Teflon felt and ligation and 8 cases with division. Surgical mortality occurred in one case[2.6%].
Patients over 14 years of age who have undergone a surgical correction of a congenital cardiac malformations during period of August 1959 through December 1993 have been reviewed. During this period, there were 6894 cases of congenital cardiac lesions consisting of 4576 acyanotic and 2318 cyanotic cases. Among them, a total of 1389 adults [20.1%with various congenital cardiac malformations, 1126 acyanotic group and 263 cyanotic group were operated on. 677 patients were male and 712 patients were female. There were 444 patients under 20 years of age, 365 patients between 20-24 years, 220 patients between 25-29 years, 138 patients between 30-34 years and 222 patients over 34 years. The most common defects were atrial septal defect which accounted for 500 cases [36.0%and another common malformations were ventricular septal defect [276 cases, 19.9% , patent ductus arteriosus [207 cases, 14.9% , tetralogy of Fallot [185 cases, 13.3%and pulmonary stenosis [44 cases, 3.2%in order of incidence. Overall operative mortality for this series was 2.7% [1.5% of acyanotic group and 7.9% of cyanotic groupcompared with 4.6% of operative mortality of total cases of congenital cardiac malformations [2.9% of acyanotic group and 16.7% of cyanotic group . This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.
Clinical and cytomorphological studies were carried out in 32 leukotic cattle from Tokachi and Kushiro districts in Hokkaido during the 12 year period from 1969 to 1980. The leukotic cattle were examined :and divided into four types(15 cases of the adult, 11 cases of the thymic, 4 casas of the calf and 2 cases of the skin types). The results obtained were as follows : 1. As for the frequency of the main clinical signs in each type, In the adult type, the main clinical signs (of decreasing order) are as follows: swelling of the superficial lymph nodes>depression and loss of weight>tachycardia>anorekia, anemia of the visible mucous membrane and tachypnea. Those of the thymic type were swelling of the thymus>swelling of the medial iliac lymph nodes> swelling of the superficial lymph nodes>tachypnea. Those of the calf type were swelling of the auperficial lymph nodes>depression and emaciation>tachypnea>anorexia, tachycardia, anemia of the visible mucous membrane and recumbency. Those of the skin type were generalized urticaria-like lesions in skin and swelling of superficial lymph nodes>and depression and loss of weight in the decreasing order of frequency. In addition, large tumor mass in the pelvic cavity and swelling of the medial iliac lymph nodes were detected through rectal palpation in 33.3% and 100% in the adult type cases, respectively. 2. As for the hematological findings, The frequency of occurrence of decreased erythrocyte counts in the decreasing order were as follows : adult>calf>thymic>and skin types. The increase in the total leukocyte count in the order of decreasing frequency were as follows: calf>thymic>adult>and skin types. The increase in the absolute lymphocyte counts was found to be at a low rate, 62.5% of all the cases examined. By contrast, the increase of 5% or more of abnormal lymphocyte rates was observed at a high rate, 96.9% of the total cases. 3. Abnormal lymphocytes were found in all cases examined for lymph nodes biopsied. 4. From the cytomorphological point of view, leukotic cells were divided into 3 types: reticulum cell, lymphoid cell and monocytic cell types. The adult type leukotic cattle were divided with reticulum cell type (66.7%), the lymphoid cell type(22.6%) and monocytic cell type(6.7%). The thymic type was lymphoip cell type(72.7%) and reticulum cell type(27.3%). In the calf type, all were lymphoid cell type while all of the skin type were reticulum cell type only. 5. The leukotic cattle had higher NP frequency in the blood and lymphoid tissue than non-1 eukotic cattle. Especially the adult type had the highest NP frequency. However, it was not recognized that NP were characteristic of leukotic cattle alone. 6. The above findings lead to the conclusion that the most effective diagnostic methods for bovine leukosis are the confirmation of swelling of the superficial and internal lymph nodes and thymus in addition to appearance of abnormal neoplastic cell in the peripheral blood and lymph nodes biopsied.
The authors made a clinical study of 80 cases of empyema who were diagnosed and treated at department of chest surgery, St. Mary`s Hospital, Chatholic Medical College, during the period of May.l964 through April.1969 and compared the empyema of infant and children with that of adults. 1. In age and sex ditribution, infant was 6 cases, childhood 22 cases and adult 52 cases. The ratio of male to female was 2.2:1. There`s a little difference in infant-childhood but prominence of males over females in adults was being 3. 3:1, in its ratio. 2. The cardinal symptoms were cough [61.3%], fever [60.0%] and dyspnea [52.8%]. The leukocytosis were observed in 83.7% of all cases, 96.2% of infant-childhood and 76.9% of adults. The hemoglobin level showed subnormal in 82.1% of infant-childhood and in 55.8% of adults. 3. Most frequent lesion to predisposing factor of empyema was pneumonia [43.7%],being prominent in infants children [64.3%] to that of adult 4. The Pathogenic organism by culture in 75 cases of empyema were staphylococuss [48%], streptococuss[9.3%], Gram[-] bacilli [9.3%], Klebsiella[2.7%], pneumococcus[4.0%], E. coli [5.4%] and no growth 21.3% in over all. Among the cases of empyema. staphlocal origin was 62.9% in infant-childfood and 39.6% adults. 5. Staphylococci were most susceptible to erythromycin [86. 1%], Kanamycin [75.0%], albamycin [61.7%] and neomycin [52.8%] but most resistant to penicillin, Chtoramphenicol and terramycin. 6. In the treatment of empyema, of 53 cases were closed thoracotomy drainage and the remainder of cases by open thoracotomy, decortication, thoracoplasty and pleuropneumonectomy. we could attain favourable results by only the closed thoracotomy in infant-childhood, 28 cases. 7. The mortality rate was 6.3% in over all; adult 3 cases, infant and children 2 cases. 3 cases of these, were due to staphylococcal infection.
The authors made a clinical study of 107 cases of empyema who were treated at Department of Thoracic Surgery of Chungnam National University Hospital during the period of Jan. 1976 through Aug. 1982 and compared the empyema of infant and children with that of adults. Following was the remits: 1. Male was predominant to female with the ratio of 2.5 to 1 and adult to infant was 2.6 to 1. 2. The cardinal symptoms were dyspnea, coughing, chest pain and fever. 3. Positive remit of bacteriological culture study was reported in 57% and the most common causative organism was staphylococcus in infant and childhood, E. coil in adult. 4. Most frequent predisposing factors of thoracic empyema in infant and childhood was pneumonia [53%], and in adult was pulmonary tuberculosis [40%]. 5. Treatment were combined with antibiotics therapy and several surgical procedures for empyema. 24 cases [22.4%] required open thoracotomy. 6. The mortality rate was 7.4% [8/107]. 86 cases [80.4%] were discharged with recovery and improvement.
Background: One of the causes of acute leukemia can be exposure to certain chemicals such as pesticides. This study determined the relationship between exposure to pesticides and the occurrence of acute leukemia in Fars province, south of Iran. Materials and Methods: Between April 2011 and April 2013 in a case-control study conducted in Nemazee Hospital in Shiraz, Southern Iran; 314 subjects diagnosed with acute leukemia (94 pediatric cases and 220 adults) were enrolled to determine any correlation between exposure to pesticides and the occurrence. Controls (n=314) were matched by sex and age. Results: There was a history of exposure to pesticides among 85% of pediatric cases and 69% of their controls and 83% of adult cases and 75% of their controls while 87.5% of pediatric cases and 90% of adult cases reported exposure to intermediate and high doses of pesticides and among the controls, the exposure to low doses of pesticides was 70.5% and 65%, respectively. Exposure to indoor pesticides was seen among most of cases and controls. Being a farmer was at a significantly more increased risk of developing acute leukemia in comparison to other jobs, especially for their children. Conclusions: Exposure to pesticides was shown to be one of the most important causes of acute leukemia. It seems that there is a need to educate the people on public health importance of exposure to pesticides especially during school time to reduce the risk of malignancies during childhood.
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