• Journal of Chest Surgery
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• v.31 no.11
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• pp.1031-1036
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• 1998

Background: Medtronic-Hall mechanical valve is a world widely using prosthesis. But, in Korea, the clinical result from Medtronic-Hall valve replacement is not frequenthy available. Materials and methods: From March 1986 to May 1990, 50 patients underwent valve replacement surgery with Medtronic-Hall valve at Pusan National University Hospital. Seventeen were male and thirty three were female and ra nging in age from 16 to 70 years of age(mean=35 years). Results: The causes of valvular lesion were rheumatic in 43 patients, bicuspid aortic valve in 3 patients, degenerative lesion in three patients and bacterial endocarditis in one patient. The operative procedures were mitral valve replacement(MVR) in 38, aortic valve replacement(AVR) in 5 and double valve replacement(DVR) in 7. The most commonly used valve size was 21mm in AVR, 29mm in MVR. Concomitant surgical procedures were performed in 15 patients; left atrial thrombectomy in 9, left atrial auricle obliteration in 6 and tricuspid annuloplasty in 5(Kay: 2, DeVega: 3). New York Heart Association functional class was mostly Class Ⅲ or Ⅳ(91.5%) preoperatively and ClassⅠor Ⅱ(87.2%) after operation. The findings of postoperative echocardiogram of LAD, LVESD, LVEDD were reduced compared with preoperative period and ejection fraction was increased compared with preoperative period. Postoperative complications were massive bleeding in three, low cardiac output syndrome in two, thromboembolism in one and fulminant hepatitis in one patient. There were three hospital deaths and their causes were low cardiac output syndrome in two and rupture of left ventricle in one patient. The 5 year survival rate was 93.65±0.71% and 10 year actuarial survival rate was 88.27±6.42%. Conclusions: Medtronic-Hall mechanical valve has low valve related complication rate. It's durability and hemodynamic performance is comparable to other mechanical valves.

• ALGAE
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• v.24 no.1
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• pp.1-29
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• 2009

A synthesis of early exploration and the discovery of marine algae in the upper North Pacific and Bering Sea is presented covering the period from the late 1730s to around 1900. Information is provided about these early efforts to gather natural objects, including seaweeds, and names of these algae are enumerated. The first collections of marine algae in this broad region were those made by steller and Kracheninnkov from the Kamchatka Peninsula,Russia,during the Second Kamchatkan Expedition (1735-1742) and were described by Gmelin (1768). The first known algal collections in Alaska were those made byMerck in his 1790-1791 visits to Unalaska Island during the Billings expedition (1785-1794). British-sponsored expeditions for commercial purposes and for exploration and dis-covery allowed surgeon-naturallist Archibald Menzies to garher seaweeds that Dawson Turner and others worked up back in Europe. Several of the Russian Expeditions during the first half of the 18'!' century had naturalists aboard. the first Russian circumnavigation of the globe (1803-1806), with the ships 'Nadeshda' and 'Neva,' under the com-mand of Capt. Adam von Krusenstern had naturalists Langsdorff, Tilesius, and Horner, all of whom collected sea-weeds. The naturalist Adelbert Chanmisso accompanied the Romanzof Expedition (1815-1818) on the Russian vessel 'Rurik' under the command of Otto von Kotzebue and made collections of algae in the Aleutians as well as in the Kurils and Kamchatka. The Lutke expedition of 1826-1829 consisted of thw ships. Feodor Lutke was in command of the 'Seniavin' with K.H. Mertens aboard as physician-naturalist, and the 'Moller' was under the command of staniukovich accompanied by the naturalist G. Kastalsky. The first American-sponsored scientific expedition (1838-1842) was that commanded by Charles Wilkes, and the algae that were collected were worked up by J.W. Bailey and W.H. Harvey. The Russian naturalist Ilya Voznesenskii spent the period 1839-1849 in Russian Americ (Alaska and northern California) energetically traveling and making numerous collections of natural objects as well as ethno-graphic artefact. His algae were described by F.j. Ruprecht back in St. petersbung. The Swedish scientific vessel, the'Vega' (1878-1880), was under the command of Nordenskiold. The naturalist F.R. Kjellman made algal collections from Port Clarence, Alaska, as well as from bering Island and St. Lawrence Island in the Bering sea. The Harriman Alaskan Expedition in the summer of 1899, with the ship 'George W. Elder,' was sponsored by railroad magnate E.H. Harriman of New York City and had several scientific personnel aborad, including the phycologist De Alton Saunders. Algae were collected in Alaska and Washington. During the same summer of 1899 a scientific expedition organized by the University of California and including W.L. Jepson, L.E. Hunt, A.A Lawson, and W.A. Setchell as participants also visited Alaska and made collections of alage from various locations.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.404-420
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• 1991

Surgical treatment of congenital and acquired heart disease preceded the development of accurate techniques for diagnosis, heart lung machine and cardiopulmonary bypass, intraoperative myocardial protection, operative techniques and cardiac anesthesia. For 5 years from Sep. 1985 to Sep. 1990, six hundred cases of open heart surgeries [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. The results were summarized as follows. 1. The annual number of OHS[cases per year] was above 100 since 1987, and the increasing rate of cases was 23.5% per year since 1986. 2. Among the total 600 cases, there were 470 cases of congenital heart diseases and 130 cases of acquired. Age range of the congenital patients was 8 months to 44 years with the mean age of 10 years, and acquired patients was 16 to 56 years with the mean age of 36 years. 3. Among the 470 congenital anomalies, there were 429 cases of acyanotic and 41 cyanotic patients. Totally, VSD was 286 cases[60.6%], ASD 103 cases[21.9%], TOF 35 cases [7.4%], PS 20 cases [4.1%], ECD 12 cases [2.0%], Ebstein`s anomaly 3 cases [0.6%], Valsalva sinus rupture 3 cases [0.6%] and others. The appropriate one stage radical operations were applied to the all congenital cases with the result of 2.6% immediate postoperative hospital mortality rate. 4. Among the 130 acquired cases, there were 122 cases of valvular heart diseases, 6 of heart tumors [5 myxoma, one malignant histiocytoma], one of LA thrombus and one of annuloaortic ectasia. Cardiac tumors and LA thrombus were removed through the atrial septal approach. Bentall procedure was adopted to the annuloaortic ectasia case. AVR, MVR and TVA [DeVega procedure] were applied to 120 valve diseases, and there were also one of OMC and one of MVA[Jerome-Kay procedure]. 5. Among the 120 valve replacement cases, there were 87 of single valve replacement cases [AVR: 8, MVR: 79], 11 of double valve replacement [AVR+MVR: 11], 12 of MVR+TVR and 10 of MVR+AVR+TVA. The total number of implanted prosthetic valves were 141. In MVR, 45 of St. Jude Medical valves, 63 of Carpentier-Edward valves and 4 of Ionescu-Shiley valves were used. In AVR, 18 of St. Jude Medical valves and 11 of Carpentier-Edward valves were used. in MVR, 29mm and 31mm sized valves were used mostly and In AVR, 23mm sized valves were used mostly. 6. Postoperatively many kinds of complications were occurred. Among them, wound problems [30 cases], low output syndrome [29 cases], arrhythmia [20 cases], pleural effusion and pneumothorax [13 cases] were occurred frequently. The postoperative immediate hospital mortality was 3.0% in total [congenital 2.6%, acquired 4.6%].