During the period of 18 months from December 1984 to May 1986, 41 cases(25.0%) of subpulmonic ventricular septal defect(VSD) were diagnosed among 164 cases of isolated VSD in the cardiac catheterization labortory. The incidence of aortic regurgitation associated subpulmonic VSD(19.5%) was much higher than that of the other types of VSD(2.4%). None of patients less than 1 year old developed aortic regurgitation, the incidence of which has increased with the age after that. That amount of left to right shunt through the VSD was smaller in the patients with aortic cusp prolapse than those without aortic cusp prolapse, and the severity of aortic regurgitation was correlated with that of aortic cusp prolapse. 10 out of 41 patients revealed more than 20mmHg pressure gradient through right ventricle outflow tract and 9 of these patient were as sociated with aortic cusp prolapse.
Aortic Valve Insufficiency ; Cardiac Catheterization* ; Cardiac Catheters* ; Heart Ventricles ; Hemodynamics* ; Humans ; Incidence ; Prolapse

No abstract available.
Animals ; Guinea Pigs* ; Guinea* ; Perilymph*

BACKGROUND: The prognosis for a hepatocellular carcinoma (HCC) is very poor because of delayed diagnosis caused by the absence of specific clinical manifestations in the early stage, the limitation of the extent of resection, the high postoperative complication rate due to associated liver cirrhosis, and the high recurrence rate due to multifocal tumorigenesis. Among the various kinds of treatment modalities for HCC, surgical resection is still recognized as the first treatment method. However, it is true that surgical resection has many problems, such as a high operative risk and a high postoperative recurrence rate. Therefore, an evaluation of the factors associated with the overall survival rate and with the recurrence rate is very important for improving the results of operative therapy for HCC. METHODS: We retrospectively analyzed the clinical and the pathological results of 44 curative hepatic resections for HCC performed at Chonnam University Hospital from 1991 to 1997. We evaluated 19 clinical and pathological factors by univariate and multivariate analysis, and we calculated the survival rate by using the Kaplan-Meier method. RESULTS: The cumulative 1-, 3-, and 5-year survival rates were 81%, 66%, and 28%, respectively. In 25 of the 44 cases, recurrences developed, and the 1-, 3-, and 5-year recurrence rates were 38%, 60%, and 65%, respectively. Factors with an independent effect on the overall survival rates were multiplicity of tumors, HBs Ag status, and Child classification. However, liver cirrhosis, ascites, prothrombin time, AFP level, and portal vein invasion were not statistically significant. CONCLUSIONS: The significant prognostic factors detected by multivariate analysis were multiplicity of tumors, HBs Ag status and Child classification. A preoperative evaluation for these factors should be done. If early diagnosis and multidisciplinary therapies are done through frequent postoperative follow-up surveys in these high risk groups, we can anticipate better long-term survival rates after a hepatectomy.
Ascites ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Child ; Classification ; Delayed Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Hepatectomy ; Humans ; Jeollanam-do ; Liver Cirrhosis ; Multivariate Analysis ; Portal Vein ; Postoperative Complications ; Prognosis ; Prothrombin Time ; Recurrence ; Retrospective Studies ; Survival Rate*

No abstract available.
Macrophages, Alveolar* ; Mycobacterium tuberculosis* ; Mycobacterium*

BACKGROUND: It is difficult to treat patients with hepatolithiasis because of recurrent or residual stones and serious postoperative complications. This study was done to compare the operation method and postoperative progression related to location of the hepatolithiasis. METHODS: Retrospective analysis was done in 234 patients who underwent operation due to hepatolithiasis from Jan. 1989 to Dec. 1998 in Chonnam University Hospital. RESULTS: The patients with left intrahepatic duct stones were 135, with right intrahepatic duct stones were 30 and with both intrahepatic duct stones were 69. In cases of resection of the liver, left lobectomy, left lateral segmentectomy, right posterior segmentectomy or right lobectomy was done. In a patient with stone in caudate lobe, caudate lobectomy was done. In non-resected group choledocholithotomy was done. Of 135 patients with left intrahepatic stones, 117 patients(86.7%) underwent hepatic resection and 18 patients(13.3%) underwent choledocholithotomy. Of 30 patients with right intrahepatic stones, 6 patients(20.0%) underwent hepatic resection and 24 patients(80.0%) underwent choledocholithotomy. Of 69 patients with both intrahepatic stones, 36 patients(52.2%) underwent resection and 33 patients(47.8%) underwent choledcholithotomy. Overall incidence of remnant stone was 28.2%. In resected group of left intrahepatic stones, the incidence of remnant stones was 8.5% and in non-resected group 33.3%. In resected group of right intrahepatic stones, the incidence of remnant stones was 0% and in non-resected group 37.5%. In resected group of both intrahepatic stones, the incidence of remnant stones was 55.6% and in non-resected group 63.6%. Incidence of postopertive complications was 22.6% and wound complication was most common. There was no postoperative mortality. CONCLUSIONS: Hepatic resection for hepatolithiasis confined to one lobe has an advantage of low incidence of remnant stone without increasing the morbidity and mortality rate. In both intrahepatic stones, the treatment is difficult, but if operation is performed with proper selection of extent of hepatic resection, favorable result would be expected.
Humans ; Incidence ; Jeollanam-do ; Liver ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries

Pulmonary Langerhans' cell histiocytosis is an uncommon granulomatous disorder of unknown cause. The authors retrospectively evaluated radiographs and computed tomographic findings of five patients with biopsy-proven pulmonary Langerhans' cell histiocytosis. The main structural abnormalities consisted of small nodules and cystic air spaces, but one case showed only pneumothorax due to bullae rupture. Its distribution has been known predominently in the upper lung fields, but in our cases, the lung lesions were distributed in the entire lung fields or predominently in the lower lung fields. We propose that pulmonary Langerhans' cell histiocytosis is extremely variable of its structural abnormalities and distribution.
Histiocytosis* ; Humans ; Lung ; Pneumothorax ; Retrospective Studies ; Rupture

No abstract available.
Hemodynamics* ; Ketanserin* ; Positive-Pressure Respiration* ; Pulmonary Embolism* ; Ventilation*

Agenesis of the right lobe of the liver is such a rare congenital anomaly that only about 40 cases have been reported in the literature. This anomaly is considered to be caused by a developmental failure of the right portal vein or by an error of mutual induction between the primitive diaphragm and the endodermal diverticulum representing the primitive liver. When the absence or hypoplasia of the right lobe is found by radiological examinations, several condition, such as liver cirrhosis, a cholangiocarcinoma, and a previous hepatic resection, must be taken into a consideration for a differential diagnosis besides agenesis. Agenesis of the right lobe could be complicated by various biliary tract diseases, including cholelithiasis, a carcinoma of the gallbladder and Mirizzi syndrome, portal hypertension, and rarely volvulus of the stomach, and these complications usually draw clinical attention. We experienced a 58-year-old female who complained of intermittent fever, chills, and jaundice and who was diagnosed with agenesis of the right lobe of the liver with multiple intrahepatic stones by using abdominal CT and MRI. Percutaneous transhepatic biliary drainage was done to relieve the obstructive jaundice, and a percutaneous transhepatic cholangiogram revealed agenesis of the right lobe and abnormal course of the biliary tract. In operative findings, there was no right lobe, and the left lateral segment was markedly enlarged with compensatory hypertrophy. However, the medial segment of the left lobe and caudate lobe was relatively normal in size. The gallbladder was located on the right side of the liver retrohepatically. A cholecystectomy and a choledocholithotomy through a choledochotomy and a retrograde approach after a subsegmentectomy of segments II and III were done.
Bile Ducts, Intrahepatic* ; Biliary Tract ; Biliary Tract Diseases ; Chills ; Cholangiocarcinoma ; Cholecystectomy ; Cholelithiasis ; Diagnosis, Differential ; Diaphragm ; Diverticulum ; Drainage ; Endoderm ; Female ; Fever ; Gallbladder ; Humans ; Hypertension, Portal ; Hypertrophy ; Intestinal Volvulus ; Jaundice ; Jaundice, Obstructive ; Liver Cirrhosis ; Liver* ; Magnetic Resonance Imaging ; Middle Aged ; Mirizzi Syndrome ; Portal Vein ; Stomach ; Tomography, X-Ray Computed

Xanthogranulomatous cholecystitis (XGC) is an uncommon, focal or diffuse destructive inflammatory process of the gallbladder that is assumed to be a variant of chronic cholecystitis. XGC is characterized grossly by irregular thickening of the gallbladder wall with the formation of a yellow mass (xanthogranuloma). Histologically the xanthogranuloma appears as yellow nodules or streaks in a thickened gallbladder wall and is composed of predominantly lipid-laden macrophages, inflammatory cells, and fibroblasts. These xanthogranulomatous foci may extend into adjacent structures, adhesions or ulcerations are often present, and fistula formation may occur. Although the pathogenesis of XGC is unclear, recurrent inflammation in the presence of calculi and biliary stasis are thought to be the main etiological factors because of the histologic evidence of chronic inflammation and the presence of gallstones in a majority of cases. XGC may lead to associated complications such as perforation, abscess, and fistula, and sometimes closely mimics a gallbladder carcinoma. During an operation for XGC, careful surgical technique is required to dissect the gallbladder and to excise the adjacent xanthogranulomatous tissue. Also a careful investigation to find the coincident gallbladder carcinoma is necessary. We report a case with XGC in a hemophilia A patient and a review of the clinical literatures.
Abscess ; Calculi ; Cholecystectomy ; Cholecystitis* ; Cholestasis ; Fibroblasts ; Fistula ; Gallbladder ; Gallstones ; Hemophilia A* ; Humans ; Inflammation ; Macrophages ; Ulcer

No abstract available.
Aorta, Thoracic* ; Ductus Arteriosus, Patent*