• Journal of Chest Surgery
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• v.15 no.4
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• pp.447-450
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• 1982

A 45 year old male officer was admitted due to upper substernal pain for 1 month, which was aggravated by swallowing. On past and family history, there was no specific history except heavy drinking. Simple chest x-ray revealed no specific abnormal findings. Preoperative esophagofiberscopy and Barium study showed midesophageal diverticulum, pulsion type, at about 2 cm below the left main bronchus. The opening of the diverticulum was located at the left posterolateral aspect of esophagus. Midesophageal false diverticulum, measuring 2 x 2 x 1 .S cm in size, was noted at about 5 cm under the aortic arch protruding through a slit-like muscular defect. After inversion of diverticular sac, interrupted sutures with 3-0 silks were done on muscular defect site, and mediastinal pleura was reinforced on the lesion with interrupted sutures. On 4th postoperative day, esophagography revealed no diverticulum or stenosis. Also esophagofiberscopy showed smooth mucosal tag without disturbance of passage. On 14th postoperative day, the patient was discharged uneventfully, and follow-up for 3 months after discharge revealed nothing abnormal symptoms. The authors report one case of midesophageal, pulsion type, false diverticulum.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.527-530
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• 2011

Purpose: Liver transplantation is a groundbreaking section in the field of surgery. Nowadays over 90% of success rate is accomplished and life expectancy of the patients has been elongated. Patients are now seeking for surgical procedures including cosmetic plastic surgery. But these patients take immunosuppressive medication and steroids, which can increase the risk of wound infection, and delay wound healing. By reviewing the case of a 21-year-old liver transplant recipient who underwent mastopexy due to breast ptosis, we discussed about the matters we should consider when performing surgery in liver transplantation recipients. Methods: The patient was a 21-year-old female who received liver transplantation from her father. She was exposed to massive amount of steroids and immunosuppressants, which led to breast ptosis. The vertical and short horizontal incision mastopexy using a medial-based pedicle was done, 29 months after the liver transplantation. Results: On postoperative day 1, she was discharged. On day 10, sutures were removed and taping was applied. There was no sign of wound infection, wound dehiscence, hematoma or bleeding. The patient was followed up at 3, 6 and 9 months after the operation. Mild recurrence of the glandular ptosis was observed but revision was not required. Conclusion: We were able to successfully operate without any complications in the liver transplant recipient. With special attention and consideration, cosmetic plastic surgery can be safely performed in organ transplantation recipients.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.665-670
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• 2021

Symptomatic cerebral vasospasm (CVS) and delayed ischemic neurologic deficit (DIND) after unruptured aneurysm surgery are extremely rare. Its onset timing is variable, and its mechanisms are unclear. We report two cases of CVS with DIND after unruptured aneurysm surgery and review the literature regarding potential mechanisms. The first case is a 51-year-old woman with non-hemorrhagic vasospasm after unruptured left anterior communicating artery aneurysm surgery. She presented with delayed vasospasm on postoperative day 14. The second case is a 45-year-old woman who suffered from oculomotor nerve palsy caused by an unruptured posterior communicatig artery (PCoA) aneurysm. DIND with non-hemorrhagic vasospasm developed on postoperative day 12. To our knowledge, this is the first report of symptomatic CVS with oculomotor nerve palsy following unruptured PCoA aneurysm surgery. CVS with DIND after unruptured aneurysm surgery is very rare and can be triggered by multiple mechanisms, such as hemorrhage, mechanical stress to the arterial wall, or the trigemino-cerebrovascular system. For unruptured aneurysm surgery, although it is rare, careful observation and treatments can be needed for postoperative CVS with DIND.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.1-8
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• 1981

Alterations in serum enzymes were studied in twenty-five patients who underwent open heart surgery in N.M.C. during the period from June 1979, to Feb. 1980. There were fifteen congenital and ten acquired heart diseases. In all patients, Rygg-Kyvsgaard five head roller pump and Polystan bubble oxygenator were used and serial determination of total level of Creatine phosphokinase [CPK], Lactic dehydrogenase [LDH], Glutamic oxaloacetic transaminase [SGOT] were made preoperatively, operation day [just after aortic clamp release, 2 hrs later, 4 hrs later, 6 hrs later], and postoperative days up to 5th day. Immediate postoperative clinical courses were also evaluated. Twenty-five patients were divided into two groups: Group A[13] was cardiopulmonary bypass time more than 95 minutes and aortic clamp time more than 45 minutes. Group B[12] was cardiopulmonary bypass time less than 95 minutes and aortic clamp time less than 45 minutes. The peak levels of SGOT, LDH in Group A were more significantly elevated than Group B [P<0.05]. But peak levels of CPK were not significant between two groups. In the view of clinical evaluation, poor clinical courses were more frequent in Group A [54%] than Group B[8%].

• Advances in pediatric surgery
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• v.15 no.2
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• pp.157-160
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• 2009

Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480 g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the $2^{nd}$ day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after $1^{st}$ operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

• Advances in pediatric surgery
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• v.9 no.2
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• pp.113-116
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• 2003

We present a case of a colonic involvement associated with necrotizing pancreatitis, with a review of the literature. A 10 year old boy had an appendectomy at the local clinic ten days ago. On admission, he complained nausea, vomiting and severe constipation. His abdomen was distended and he had tenderness on the left abdomen. Laboratory and radiologic studies revealed findings consistent with acute pancreatitis with colonic complication. He was treated conservatively for 30 days but did not improve. On hospital 30th day, abdominal pain developed and his vital sign changed. Abdominal CT suggested ischemic change of the transverse colon. At laparotomy, the left colon showed stenosis. The greatly distended transverse colon was resected and a transverse end colostomy was done. He was discharged at postoperative 45th day with improvement and colostomy closure was performed 8 months later.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.422-427
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• 1978

Alterations in the serum and urine potassium were studied in twenty patients who underwent open heart surgery in National Medical Center during the period from Jan.1978 to June 1978. There were twelve cases congenital heart disease and eight acquired heart disease. Rigg-Kyvsgaad mark IV roller pump and Polystan bubble oxygenator were used in all patients. Hemodilution was carried out by priming the oxygenator with Hartmann`s solution. Measurements were made of the serum electrolyte, gas analysis and twenty four hour urine electrolytes. During the bypass, the serum potassium decreased Significantly from 4.2?.47 to 3.6?. 72 mEq. per liter. [p<0.05] Fifty seven miliequivalant of potassium chloride were added during operation-urine potassium was higher in the diuretic group than in the non diuretic group. Plasma potassium level in the diuretic group was more significantly reduced than nondiuretic group. In this series large amount of urine potassium loss was noted on the day of operation, the first and second post operative day.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.772-777
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• 1988

Because of increasing myocardial damage by normothermic arrest, most of cardiac surgeons now uses many kinds of method reducing myocardial injury, such as systemic hypothermia, topical cooling and cold cardioplegic solutions. And phrenic nerve paralysis has been reported with the use of iced slush for topical cooling. So we reviewed the preoperative and postoperative chest X-rays of 54 patients undergoing open heart surgery with the use of iced slush for topical cooling to find phrenic nerve paralysis. Four of 54 patients were known to have phrenic nerve paralysis. The first time known to develop phrenic nerve paralysis was from POD 4 1 day to POD 4 3 day and the phrenic nerve paralysis resolved within a month postoperatively except one. A patient have had phrenic nerve paralysis persistently over 7 months. And the effect of unilateral phrenic nerve paralysis was of no clinical significance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.206-210
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• 2007

This study observed the frequency of post-surgical infection according to post-surgical application of antibiotics in order to evaluate the benefits of the use of antibiotics after the orthognathic surgery. 349 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The mean(SD) age of the 349 patients was 22.7(${\pm}4.25$) with a male-female ratio of 168:181. 226 patients received only 1.0g of a third-generation cephalosporin(Cefpiramide) intravenously 30 minutes prior to the surgery. Likewise, 123 patients received 1.0g of Cefpiramide 30 minutes prior to the surgery and twice daily longer than the third day after surgery. The mean(SD) duration of administration was 4.75(${\pm}0.89$) day. The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. However, 14 patients of 226 patients received antibiotics only prior to the surgery developed postoperative infection, 2 patients of 123 patients received antibiotics longer than postoperative 3 days developed postoperative infection. Postoperative infection frequency showed no significant difference between the two groups(p=0.094). Also, bi-maxillary operation and mandibular operation alone, showed no significant difference in the frequency of post-surgical infection when antibiotics had been continuously used after the surgery. From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.619-623
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• 1987

We experienced a surgical case of esophageal atresia and tracheoesophageal fistula combined with imperforated anus, tracheal bronchus in a one day baby. A vacuum delivered full term baby, weighing 4.1 Kg showed grunting respiration, repeated regurgitation and distended abdomen after birth. Esophagogram revealed markedly dilated proximal esophagus as blind pouch and also noted displaced type of tracheal bronchus of right upper lobe by incidental bronchogram. Surgical correction with Haight anastomosis was performed successfully on the second day.