• Journal of Chest Surgery
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• 제28권12호
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• pp.1113-1121
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• 1995

From August, 1986 to December, 1993, mitral valve replacement was performed in 178 patients. Of the valve implanted, 114 were St.Jude Medical, 47 Duromedics, 16 Carpenter-Edward and 1 Ionesc-Shiley. The hospital mortality rate was 2.8%[5 patients and the late mortality rate was 7.5%[13 patients . The causes of hospital death were LV rupture in 1, renal failure in 1, cardiac tamponade in 1, valve malfunction in 1 and hypoxic brain damage in 1. The causes of late death were sudden death in 6, congestive heart failure in 4, brain ischemic injury in 3. Follow-up was done on 155 surviving patients : mean follow-up period was 50.94$\pm$8.04 months. The actual survival rate was 88.2% at 8 years. We concluded, therefore, that good clinical results could be achieved with mitral valve replacement in mid-term follow-up, and long-term follow-up is also necessary.

• Journal of Chest Surgery
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• 제45권4호
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• pp.272-274
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• 2012

Killian-Jamieson diverticulum is a rare diverticular disease. This disease differs from Zenker's diverticulum in its location and mechanism. Various treatment modality have been attempted, but traditional surgical treatment has been recommended for a symptomatic Killian-Jamieson diverticulum due to the concern of possible nerve injury. We performed surgical treatment by cervical incision. We report here on a case of Killian-Jamieson diverticulum and we briefly review the relevant literature.

• Journal of Chest Surgery
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• 제26권10호
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• pp.791-797
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• 1993

We evaluated forty cases of traumatic diaphragmatic ruptures that we have experienced from Mar. 1976 to Mar. 1992. Thirty patients were male and 10 were female[M:F=3:1]. The age distribution was ranged from 2 to 76 years with the mean age of 35 years. The traumatic diaphragmatic ruptures were due to blunt trauma in 26 cases[traffic accident 20, fall down 4, others 2] and penetrating trauma in 14 cases[stab wound 13, gun shot 1]. In the blunt trauma, 21 of 26 cases were diagnosed within 24 hours after injury and all cases except one in penetrating trauma were diagnosed within 24 hours. In the blunt trauma, the rupture site was located in the left in 20 cases and in the right in 6 cases. In the penetrating trauma, the rupture site was located in the left in 10 cases and in the right in 4 cases. The repair of 40 cases were performed with thoracic approach in 19 cases, thoracoabdominal approach in 17 cases and abdominal approach in 4 cases. The postoperative mortality was 7.5 %[3/40]. The causes of death were septic shock[1], acute renal failure[1] and hypovolemic shock[1].

• Journal of Chest Surgery
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• 제25권2호
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• pp.183-187
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• 1992

Reconstructive surgery for corrosive esophageal stricture was performed in 392 patients at National Medical Center from 1959 to 1990 Between Jan. 1971 and Dec. 1990, 23 cases were experienced stenotic anastoma of neck after reconstructive surgery for corrosive esophageal stricture. The major procedure of esophageal reconstruction was colon interposition without resection of the strictured esophagus except jejunal interposition in 1 case. There were 12 males % 11 females, and mean age was forty years. The caustic materials were 16[70%] alkali and 7[30%] acid. Half of the cases had hypopharyngeal injury. After reconstructed surgery, dysphagia was developed immediate in 65%, from 2 months to 5 months in 31%, and from years in 4%[1 case]. The complications were anastomatic leakage in 13 cases, anastomatic stenosis in 8 cases, graft gangrene in 1 case, and cancer development in 1 case. The therapeutic procedures were end-to-end anstomolis & partial resection of stenotic anastoma in 18 cases, bourgination in 2 cases, and coin interposition with graft removal in 3 cases. The therapeutic results were excellent in 16 cases, mild discomfort in 3 cases, poor in 3 cases, and death in 1 cases.

• Journal of Chest Surgery
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• 제18권4호
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• pp.812-816
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• 1985

In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.

• Journal of Chest Surgery
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• 제1권1호
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• pp.75-80
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• 1968

This is a case report of traumatic arterial injuries with false aneurysm & arterio-venous fistula treated surgically at National Medical Center. 3 cases were A-V fistula and 2 cases only false aneurysm. Physiological disturbance were produced by only arteriovenous fistula; In one case ulceration of mid. 1/3 tibia due to diminished arterial flow and in 2 cases left ventricular hypertrophy, in which cases Bramhan`s sign were positive. Removing out the fistulous lesions and aneurysm, all of the arterial continuities has been reconstructed by means of end to end anastomosis, Dacron graft and vein graft, veins were managed by ligations of both ends in two cases and end to end anostomosis in one case. Immediate post operative results were good, and two cases were followed for 10 months.

• Journal of Chest Surgery
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• 제23권3호
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• pp.522-526
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• 1990

We have experienced 2 cases vocal cord paralysis after open heart surgery. One was a postoperatively developed right unilateral vocal cord paralysis after prosthetic mitral valve replacement with tricuspid valve annuloplasty. The other was a postoperative left unilateral vocal cord paralysis after prosthetic aortic and mitral valve replacement with tricuspid annuloplasty. They were intubated for forty-eight and seventy-two hours but after extubation complained of hoarseness, aphonia, anxiety, and ineffective coughing Indirect laryngoscopy performed at about postoperative one week, revealed partial paralysis and decreased mobility of the vocal cord. After active phonation therapy, symptoms were improved gradually and in the follow up indirect laryngoscopy, the vocal cord paralysis was improved. The symptoms were recovered completely at about postoperative one month in both. The cause of vocal cord paralysis after open heart surgery may be any retraction or stretching injury to the recurrent laryngeal nerve, especially right side, during median sternotomy retraction and open heart operation procedures. As a result, avoid of excessive spread of median sternotomy retractor and excessive manipulation and retraction of the heart during open heart procedures will reduce the occurrence of the vocal cord paralysis.

• Journal of Chest Surgery
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• 제27권8호
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• pp.643-649
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• 1994

We evaluated sixteen patients of traumatic diaphragmatic injuries that we have experienced from Jan. 1987 to Aug 1993. Age was ranged from 6 to 71 years, predominantly in the fourth and fifth decades. 13 were male and 3 were female, a ratio of 4.3: 1. Blunt trauma was develped in 11 [Lt 7, Rt 4], penetrating trauma in 5 [Lt 2, Rt 3]. Preoperative diagnosis of diaphragmatic injury was possible in 8 patients [72.2 %] in blunt trauma, and 1 patient [20 %] in penetrating trauma. 8 cases[54.5%] in blunt trauma, and 4 cases in penetrating trauma were treated within 24 hours,meanwhile, patients treated after 10 days were 3, all by blunt trauma.The repair of 16 cases were performed with thoracic approach in 4 cases, thoracoabdominal approach in 3 cases, and abdominal approach in 9 cases. The herniated organs in thorax were stomach [5], colon [3], liver [2], and pancreas [1]. Postoperative complication were developed in 9cases[56.3%] significantly related with delayed operation time [p < 0.01 ]. Hospital mortality was 12.5 % [2/16], and the causes of death were hypovolemic shock in one and hepatic failure due to portal vein rupture in another.

• Journal of Chest Surgery
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• 제30권6호
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• pp.621-624
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• 1997

하부 요추 추간판 탈출증시에 척추 후궁 절제술 및 추간판 제거술은 흔히 실행되며, 그로 인한 혈관 손상 합병증은 드물게 생기고 있다. 혈관 손상으로 인해서 수술 환자의 혈압이 떨어져도 외부로 출혈이 없으면 무시되기도 하지만, 만약 수술후 환자의 혈압이 심하게 떨어지거나, 저혈압 상태가 오래 지속된다면, 먼저 혈관 손상을 의심해야 하며, 즉시 개복술을 시행해야 된다. 부산 백병원 흉부외과 의국에서는 2례에 대한 경험을 했기에 보고한다.

• Journal of Chest Surgery
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• 제44권1호
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• pp.64-67
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• 2011

Constrictive pericarditis is a rare complication after coronary artery bypass grafting In most cases pericardiectomy is required as a definitive treatment. However, there are several types of constrictive pericarditis such as transient cardiac constriction. Some types of constrictive pericarditis can only be managed with medical therapy. We report a 72-year-old female patient who developed subacute transient constrictive pericarditis with persistent left pleural effusion as a result of postcardiac injury syndrome. The patient went through coronary bypass surgery that was successfully treated with postoperative steroid therapy.