BACKGROUND: Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. MATERIAL AND METHOD: From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. RESULT: There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. CONCLUSION: Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.
Follow-Up Studies ; Humans ; Intubation, Intratracheal ; Mortality ; Tracheal Stenosis* ; Vocal Cord Paralysis ; Wound Infection

No abstract available.
Cardiopulmonary Bypass* ; Lipoproteins* ; Plasma*

Diverse developments in the field of tissue engineering have stimulated much research on tissue production. However, studies on fat tissue still remain insufficient. The purpose of this study is to examine if alginate gel and collagen gel can be used as a three-dimensional scaffold for the culture of preadipocytes, and if these gels can induce preadipocytes to differentiate into mature adipocytes. The preadipocytes harvested from rat epididymal fat pads were three-dimensionally cultured in 1%, 2% alginate gel and collagen gel for 14 days. The morphology, number, and activity of preadipocytes were examined during the experimental period. The results were as follows; 1. The preadipocytes of monolayer culture were spindle shape with rich cytoplasm. The preadipocytes of collagen gel were multipolar or star-like in shape and there was no oil-red 0 stained cell until 14 days. However, the preadipocytes in alginate gel were round and some of cells transformed into mature fat cells which were stained by oil-red 0 after 14 days. 2. The number of preadipocytes in collagen gel continuously increased for 14 days, and significantly increased compared to that of preadipocytes in monolayer culture after 7 days. However, the number of preadipocytes in alginate gel significantly decreased compared to that of preadipocytes in monolayer culture and collagen gel for 14 days, and there was no difference between 1% and 2% alginate gel groups in the number of preadipocytes. 3. The activity of preadipocytes in collagen gel was decreased until 7 days, but not significantly different after 10 days, when compared with that of preadipocytes in monolayer culture. And the activity of preadipocytes in alginate gel was decreased than that of preadipocytes in monolayer culture until 10 days, was higher than that of preadipocytes in collagen gel until 7 days, but was not significantly different compared with that of preadipocytes in monolayer culture and collagen gel on the 14th day. There was no difference between 1% and 2% alginate gel groups in activity of preadipocytes for 14 days. The results suggest that collagen gel are adequate three-dimensional scaffolds in which the proliferation of preadipocytes can be induced, and that alginate gel can be used as a three-dimensional scaffold that has the ability to induce differentiation of preadipocyte although the proliferation of preadipocytes is inhibited.
Adipocytes ; Adipose Tissue ; Animals ; Collagen* ; Cytoplasm ; Gels* ; Rats ; Tissue Engineering

BACKGROUND: The authors have modified the method of Ravitch technique. MATERIAL AND METHOD: This technique was applied to 6 patients out of 18 patients who underwent corrective surgery from May 1987 to July 1999. The technique is quite different from that of Ravitch. We did not divide the intercostal muscle bundles from the laterals of sternum and the Akin's struts were placed retrosternally crossing the chest horizontally to prevent flail motion during immediate post-operative period and retraction of the sternum afterwards. Anterior sternal osteotomy instead of the posterior one was performed for the latest 3 cases which made operative procedure more simple and easy. The struts were removed one year later. RESULT: Compared to the hospital stay of the patients who received standard Ravitch method that of the six cases who received our modification was definitely shortened from 13.1 days to 8.3 days(p<0.0000). Flail motion was not noted in any patient and chest wall stability was obtained more easily with this technique. CONCLUSION: Our modification is recommendable for correction of funnel chest in regards to shorter operation time better chest wall stability shorter hospital stay and less complication.
Funnel Chest* ; Humans ; Intercostal Muscles ; Length of Stay ; Osteotomy ; Sternum ; Surgical Procedures, Operative ; Thoracic Wall ; Thorax

PURPOSE: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. METHODS: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary RESULTS: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. CONCLUSION: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.
Adult ; Anesthesia, General ; Cicatrix ; Depression ; Follow-Up Studies ; Forehead ; Frontal Sinus ; Humans ; Male

The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. I recommend operating on the iliac vein first rather than the lower venous tree.
Catheters ; Iliac Vein ; Lower Extremity* ; Muscles ; Thigh ; Thrombectomy ; Veins* ; Venous Thrombosis ; Venous Valves

Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patient of myasthenia gravis underwent radical thymectomy during last eight years, and its result was analyed. Complete remission was achieved in five patients(31 %) and pharmacological or symptomatic improvement in seven patients(44 %), thus giving a total remission in 12 patients(75 %). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.
Autoimmunity ; Diagnosis ; Humans ; Myasthenia Gravis* ; Rare Diseases ; Thymectomy

OBJECTIVES: The surgical mortality of congenital heart defects has been reduced for the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Fallot. Some risk factors were analyzed. METHODS: Three hundred and sixty six patients underwent surgical intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cy anotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. RESULTS: The overall surgical mortality was 10.4%. Most deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/10 1). Risk factors of mortality in open heart surgery were age(p<0.0001), body weight(p<0.0001), pump time(p<0.0001), aortic cross clamp time(p<0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding t etralogy of Fallot(odds ratio=0.27). CONCLUSIONS: Even though the most important risk factor was disease entity, technically feasible factors influencing mortality indicated by univariate analysis should be improved.
Heart Defects, Congenital* ; Humans ; Infant ; Infant Mortality ; Mortality* ; Multivariate Analysis ; Risk Factors* ; Tetralogy of Fallot ; Thoracic Surgery

From May 1988 to December 1995, 77 patients underwent surgical resection for primary non-small cell lung cancer at GNUH, and were evaluated clinically. There were 65 males and 12 females(M:F=5.4:1), and the peak incidence of age was 6th decade of life(44.5%). The major symptoms were cough, hemoptysis and chest pain due to anatomical effects of the mass. Histopathologically, squamous cell carcinoma was 81.8%, adenocarcinoma 14.3%, and adenosquamous carcinoma 3.9%. There was no significant difference in survival among three groups. The pneumonectomy was performed in 26 cases(33.8%), lobectomy 30 cases(38.9%), bilobectomy 9 cases(11.7%), and overall resectability was 84.4%. The postoperative official stagings were as follows ; 26 patients of stage I(34%), 14 patients of stage II(18%), 22 patients of stage IIIa(29%), 14 patients of stage IIIb(18%), and one patients of stage IV(1%). In all cases, 3 year survival rate are showed stage I 83%, stage II 26%, stage IIIa 17%, and stage IIIb 0%.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Chest Pain ; Cough ; Hemoptysis ; Humans ; Incidence ; Lung Neoplasms ; Male ; Pneumonectomy ; Survival Rate

Previously, the majority of human embryonic stem cells and human induced pluripotent stem cells have been derived on feeder layers and chemically undefined medium. Those media components related to feeder cells, or animal products, often greatly affect the consistency of the cell culture. There are clear advantages of a defined, xeno-free, and feeder-free culture system for human pluripotent stem cells (hPSCs) cultures, since consistency in the formulations prevents lot-to-lot variability. Eliminating all non-human components reduces health risks for downstream applications, and those environments reduce potential immunological reactions from stem cells. Therefore, development of feeder-free hPSCs culture systems has been an important focus of hPSCs research. Recently, researchers have established a variety of culture systems in a defined combination, xeno-free matrix and medium that supports the growth and differentiation of hPSCs. Here we described detailed hPSCs culture methods under feeder-free and chemically defined conditions using vitronetin and TeSR-E8 medium including supplement bioactive lysophospholipid for promoting hPSCs proliferation and maintaining stemness.
Animals ; Cell Culture Techniques ; Embryonic Stem Cells ; Extracellular Matrix ; Feeder Cells ; Human Embryonic Stem Cells ; Humans ; Induced Pluripotent Stem Cells ; Pluripotent Stem Cells ; Stem Cells