No abstract available.
Ductus Arteriosus, Patent* ; Endarteritis*

Between October 1991 and May 1995, 256 "New Duromedics Valve"(Edward TEKNA Bileaflet Valve) were implanted in 208 adult patients(171 mitral, 82 aortic and 3 tricuspid) with age ranging from 18 years to 70 years(mean 48.2+/-11.6 years). Postoperative complication rates were 12.2%, but there was none valve related one. Overall early mortality rate were 1.4%(1.6% for MVR, 2.1% for DVR, and none for AVR or TVR) respectively. Follow-up was 99% completed ranging in duration from 2 months to 46 months. There were 6 valve-related late complications(2.9%) with 2 patients with upper gastrointestinal bleeding, 2 with cerebral thromboembolism, 1 with valve thrombosis and 1 with valve endocarditis. Freedom from these valve-related major complications were 89.9% at 40 months. There were 5 late deaths(2.4%). one of these late deaths was considered valve-related. Overall actuarial survival rates at 40 months were 95.5%, 96.8% for mitral, 97.1% for aortic, 100% for tricuspid, and 92.0% for double valve replacement respectively. Preoperative New York Heart Association functional class were 2.9, and 1.3 in post-operative state. We have been trying to keep the international normalized ratio(INR) with range of 2.5 to 3.0. The INR of 4 patients of 5 with anticoagulant ralated complications was beyond the range. To reduce the rate of anticoagulant related complications, we felt very strongly that the INR should be kept between 2.5 and 3.0. In our cases, there was no structural failure or significant hemolysis in the absence of periprosthetic leak. This experience encourages us to continue using the "New Duromedics Valve".
Adult ; Endocarditis ; Follow-Up Studies ; Freedom ; Heart ; Heart Valve Prosthesis ; Hemolysis ; Hemorrhage ; Humans ; International Normalized Ratio ; Mortality ; Postoperative Complications ; Survival Rate ; Thromboembolism ; Thrombosis

A clinical study of 71 cases of pulmonary tuberculosis that had had surgical resection during the period of 7 years and 6months from January 1989 to June 1996 in National Masan Tuberculosis Hospital. The results were as follows : 1. The ratio of male to female was 3.7 : 1 and in the age incidence the fourth decade was 22%, the third decade 15%. 2. Although medical treatment was performed for more than 3 to 6 months, preoperatively the conversion failure rate of positive sputum to negative state was 66.2%(47 cases). Of the failure cases, multiple-drug-resistant(MDR) patients were 41 cases(87.2%). 3. In MDR group, preoperatively conversion failure rate was 71.9%. 4. From the view of indication for lung resection on the radiographic finding, cavitary lesions were 43 cases(60.6%), destroyed lung lesions were 24 cases(33.8%). 5. The incidence of postoperative complication was 28.2%(20 cases). All cases were MDR group and the most common of complication was tuberculosis spreading. 6. In bilateral lesion, incidence of postoperative tuberculosis spreading was 25%(7 cases). Of the 7 cases, there was the cavitary lesion in 6 cases(86.7%). 7. Total conversion rate of AFB positive sputum to negative state related to resectional sugery was 76.6% and in MDR group conversion rate of AFB positive sputum to negative state was 73.2%. Conversion rate of MDR group with bilateral lesion was the lowest(60%). Conversion rate of drug-sensitivity group was 100% regardeless of lesions site. In conclusion, despite of long-standing medical treatment, it is difficult to converse sputum-positive to negative state in multiple-drug resistance patients and that increases postoperative complications such as tuberculosis relapse as a lack of appropriate drugs postoperatively. Postoperative conversion rate of sputum-positive to negative state was decreased in multiple-drug resistance patients. Because multiple-drug resistance patients have increased due to several factors in Korea, it is important to prevent spreading of multiple-drug resistnce patients through the aggressive operative treatment. When the first medical therapy is fail or drug-resistance is found, operative treatment should be considered with the secondary medical therapy. The operation should be aggressively attempted even though at first medical treatment if indicated.
Female ; Hospitals, Chronic Disease ; Humans ; Incidence ; Korea ; Lung ; Male ; Postoperative Complications ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

There are many kinds of treatments for hepatocellular carcinoma (HCC) such as surgical resection, liver transplantation, chemotherapy, interventional therapy [TACE, ethanol embolization, Immuno -chemoembolization, I131 -lipiodol embolization], thermal therapy, cryotherapy, and radiation therapy. Generally spontaneous remission is not common in HCC, however underlying mechanism of spontaneous remission is uncertain. We report a case of complete remission after one time TACE in ruptured HCC with review of literature about the effect of TACE and spontaneous remission. We conclude that arterial embolization is an effective alternative to surgery for hepatic hemostasis in patients with spontaneous rupture of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Cryotherapy ; Drug Therapy ; Ethanol ; Hemostasis ; Humans ; Liver Transplantation ; Remission, Spontaneous ; Rupture, Spontaneous

Amiodarone is a di-iodated benzofuran derivative that is commonly used to treat patients with various cardiac arrhythmias. It is associated with side effects that involve the liver, thyroid, and other organs. Approximately 1-3% of patients treated with amiodarone suffer from symptomatic liver disease. Thyroid dysfunction occurs in 10% of patients treated with amiodarone. A 65-year-old woman with coronary heart disease and atrial fibrillation was administered with amiodarone. She developed nausea, vomiting, dyspepsia, and sweating within 9 months of amiodarone administration (200 mg orally once a day). Results of the laboratory finding showed increased hepatic enzymes, and low thyroid hormone levels. A liver biopsy showed irregular arrangement of hepatocytes and diffuse micro- and macrovesicular fatty changes. Electron microscopy findings showed pleomorphic mitochondria with crystalloid inclusions and membrane-bound lysosomal structures. The liver and thyroid functions returned to normal, after the amiodarone was stopped. We describe an unusual case in which amiodarone induced hepatitis and hypothyroidism simultaneously. Physicians should take a close look to the adverse event when using amiodarone which can cause adverse effects in multiple organs.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Arrhythmias, Cardiac/drug therapy ; Drug-Induced Liver Injury/*complications/pathology/*radiography ; Female ; Fibrosis/pathology ; Humans ; Hypothyroidism/*chemically induced/*complications ; Microscopy, Electron ; Mitochondria/drug effects/metabolism ; Tomography, X-Ray Computed ; Treatment Outcome

We experience a case of pseudopolycytemia in dilated cardiomyopathy in a 62 years old man with chronic alcoholism. The patient was successfully managed by stress reduction, stopping of smoking, abstaining from alcohol drinking, use of digoxin, small dose lasix, and phlebotomy. To our knowledge, this is the first case of pseudopolycytemia in dilated cardiomyopathy in Korea. We reported this case with a review of literatures.
Alcohol Drinking ; Alcoholism ; Cardiomyopathy, Dilated* ; Digoxin ; Furosemide ; Humans ; Korea ; Phlebotomy ; Smoke ; Smoking