1.Aortopulmonary Fistula after Surgical Intervention of Acute Aortic Dissection.
Kwang Jo JO ; Jae Wook NO ; Chong Su WOO
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(2):178-181
Among the late postoperative complications of the acute dissection of aorta, the fistula between dilated distal aorta and pulmonary parenchym is so rare that only few case have been reported sporadically. Although the aortopulmonary fistula is one of a fatal condition that needs prompt surgical intervention, with an appropriate management it is well controllable condition. Early diagnosis and urgent surgical intervention is the only way to prevent catastrophic hemorrhage. We experienced a surgical management of aortoplumonary fistula which occurred between upper lobe of the left lung and distal aortic dilatation of previous aortic bypass graft which was performed for Debakey type I acute aortic dissection.
Aorta
;
Aortic Aneurysm
;
Dilatation
;
Early Diagnosis
;
Fistula*
;
Hemorrhage
;
Lung
;
Postoperative Complications
;
Transplants
2.Surgical Treatment of the Congenital Esophageal Atresia.
Pil Jo CHOI ; Hee Jae JUN ; Yong Hun LEE ; Kwang Jo JO ; Si Chan SUNG ; Chong Su WOO
The Korean Journal of Thoracic and Cardiovascular Surgery 1999;32(6):567-572
BACKGROUND: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. MATERIAL AND METHOD: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. RESULT: There were 21 male and 6 female patients. Mean birth weight was 2.62+/-.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). CONCLUSION: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Birth Weight
;
Cause of Death
;
Colon
;
Constriction, Pathologic
;
Empyema
;
Esophageal Atresia*
;
Female
;
Humans
;
Infant
;
Infant, Newborn
;
Male
;
Mortality
;
Retrospective Studies
;
Tracheoesophageal Fistula
3.Mutagenic Activity of Organic Pollutans in Drinking Water in Seoul.
Dong Chun SHIN ; Jae Yeon JANG ; Seong Joon JO ; Yong CHUN
Korean Journal of Preventive Medicine 1988;21(2):284-294
To measure the mutagenic activity of micro-organic pollutants in drinking water, mutagenic test was conducted using Salmnella typhimurium TA 98 strain on the water sample taken from three water supply station and six tap water in Seoul in July and November 1987. The results were as follows : 1. The average amounts of organic matters in raw, treated, and tap water sampled in July were 0.38mg/l, 0.28mg/l, and 0.45mg/l, respectively, and sampled in November were 0.34mg/l, 0.24mg/l, and 0.22mg/l, respectively. The amount of organic matters of tap water sampled in November did not increase while that of tap water sampled in July increased compare to those of raw or treated water. 2. The amount of organic matters is the highest in neutral fraction compare to acidic and basic fractions. 3. In the five out of six tap water and raw water of Paldang and Kuui station sampled in July, the mutagenic ratios were greater than two (both direct and indirect mutagenicity). 4. In the three out six tap water and raw and treated water of Kuui station sampled in November, the mutagenic ratios were greater than two. 5. While mutagenic were low in acidic and basic fraction, they were high in neutral fraction. The samples which had high mutagenic activity in the total amount also showed high mutagenic activity in neutral fraction. 6. While mutagenic activity was decreased after the treatment of water, it was increased in tap water as the distance from the water supply station increases.
Drinking Water*
;
Drinking*
;
Seoul*
;
Water
;
Water Supply
4.Thrombolytic Therapy in the 8 Cases of left Ventricular Thrombus after Transmural Anterior Myocardial Infarction.
Jae Lyun LEE ; Jong Won PARK ; Dong Gu SHIN ; Young Jo KIM ; Bong Sup SHIM
Korean Circulation Journal 1996;26(1):130-137
The 8 cases of left ventricular thrombus detected by the 2 D echocardiography or left ventriculography, after acute transmural anterior myocardial infarction were effectively lysed by the thrombolytic agents and heparin therapy. The thrombolytic agents were either urokinase or tissue plasminogen activator. Urokinase was infused intravenously at a dose of 1.0 million unit for three days. And tissue plasminogen activator was infused at a dose of 100mg for a day. In all cases, the thrombi were completely lysed. At follow up, no recurrence of left ventricular thrombus was found. We have experienced 2 cases of peripheral embolization in which, left ventricular thrombi were protruding nonmobile type. The one was the embolic cerebral infarction, the other was transient hoarseness and paresthesia on the left foot, which may be transient ischemic attack. These results show that left ventricular thrombi can be treated by intravenous thrombolytic agents without life-threatening complication. However, for the better establishment of the risk and benefit of therapy further investigation is needed.
Cerebral Infarction
;
Echocardiography
;
Fibrinolytic Agents
;
Follow-Up Studies
;
Foot
;
Heparin
;
Hoarseness
;
Ischemic Attack, Transient
;
Myocardial Infarction*
;
Paresthesia
;
Recurrence
;
Thrombolytic Therapy*
;
Thrombosis*
;
Tissue Plasminogen Activator
;
Urokinase-Type Plasminogen Activator
5.A Case of Squamous Cell Carcinoma of The Ovary Showing Complete Remission to Combination Chemotherapy Composed of Paclitaxel and Cisplatin.
Jin Dong JEON ; Eun Gyung CHOI ; Eun Mi JO ; Young Tae KIM ; Jae Wook KIM
Korean Journal of Obstetrics and Gynecology 2000;43(8):1492-1496
No abstract available.
Carcinoma, Squamous Cell*
;
Cisplatin*
;
Drug Therapy, Combination*
;
Female
;
Ovary*
;
Paclitaxel*
6.Color Doppler Assessment of Mitral Regurgitation in Childhood.
Jo Sam KOO ; Jae Won HUH ; Yang Dong PARK ; Hyun Kee CHUNG ; Ho Joon KIM
Journal of the Korean Pediatric Society 1989;32(6):773-778
No abstract available.
Mitral Valve Insufficiency*
7.Experimental study on healing process of autogenic demineralized bone
Jae Eun LEE ; Dong Keun LEE ; In Woong UM ; Young Jo KIM ; Jang Yeon KIM
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 1993;15(3):199-210
No abstract available.
8.Multilevel Dumbbell Tumor of the Posterior Mediastinum: 1 Case Report.
Dong Myung HUH ; Byung Ho KIM ; Jae Hoon JO ; Dong Gee KANG
The Korean Journal of Thoracic and Cardiovascular Surgery 1999;32(8):768-771
A 45 year old man was admitted for further examination of an abnormal shadow of the right posterior mediastinum. The patient suffered from dysesthesia in the right thoracic wall of dermatome T7. CT scan and MRI revealed that two separate tumors had developed in the right paravertebral area linked to the vertebral canal via an intervertebral foramina. One-stage removal of the tumors were performed safely through the right posterolateral thoracotomy following the resection of the rib head and vertebral pedicle. The tumors were confirmed as histologically neurilemomas. The postoperative course was uneventful.
Head
;
Humans
;
Magnetic Resonance Imaging
;
Mediastinal Neoplasms
;
Mediastinum*
;
Middle Aged
;
Neurilemmoma
;
Paresthesia
;
Ribs
;
Thoracic Wall
;
Thoracotomy
;
Tomography, X-Ray Computed
9.Early and Mid-Term Results after Operations for Pulmonary Atresia with Intact Ventricular Septum.
Si Chan SUNG ; Hee Jae JUN ; Kwang Jo JO ; Chong Su WOO ; Hyoung Doo LEE
The Korean Journal of Thoracic and Cardiovascular Surgery 2000;33(6):476-486
BACKGROUND: Pulmonary atresia with intact ventricular septum(PA/IVS) is an anatomically heterogenous anomaly with a variety of surgical strategies possible. The purpose of the study is to evaluate the influence of right ventricular size on the early and midterm results of surgical repair of PA/IVS. MATERIAL AND METHOD: Medical records of 20 consecutive patients with PA/IVS operated on between January 1993 and August 1999 were retrospectively reviewed. There were 12 boys and 8 girls whose ages ranged from 2 days to 14.5 months (median 6 days). Their body weight ranged from 2.52kg to 9.35 kg(median 3.18kg). The preoperative Z-value of the diameter of the tricuspid valve(T-valve) was less than or -4 in 5 patients, between -4 and -2 in 1, between -2 and 0 in 7, between 0 and 2 in 6, and greater than or 2 in 1. All patients who had z-value of tricuspid valve greater than -2.05 were attempted biventricular repair(n=15) and all patients who had it smaller than -4.4 underwent systemic-pulmonary shunt operation only(n=3) or bidirectinal cavopulmonary shunt with right ventricular reconstruction(n=2). RESULT: Two early deaths(2/20, 10%) occurred. Both were infants who underwent transannular patch with shunt. One of these two had huge right ventricle(Z-value of tricuspid valve = 5). There were 2 late non-cardiac deaths 3 and 7 months after operations respectively. Follow-up was completed in all children at a mean of 35.3 months(range, 5 to 54 months). 10 of 11 survivors who underwent transannular patch or valvotomy with or without shunt procedure were in NYHA functional class I even though some of them had small interatrial communication or patent shunt. All three patients who had shunt procedure only at initial palliation completed Fontan procedures with no death. Two patients who underwent right ventricular outflow reconstruction with bidirectional cavopulmonary shunt were also in good condition. CONCLUSIONS: The transanular RVOT patch or valvotomy with or without systemic-pumonary shunt as an initial palliative procedure to achieve biventricular repair for the patients who had neither too small nor too large right ventricle(-2.05< or =Z-value of T-value of T-valve< or =2) could be performed at low operative risk(1/14 7.1%). Systemic-pulmonary shunt procedure and bidirectional cavopulmonary shunt procedure for the patients who had small right ventricle(Z-value of T-valve< or =4.4) could be also performed with low risk. But a patient with huge right atrium and ventricle(Z-value of t-valve=5) had poor operative result.
Body Weight
;
Child
;
Female
;
Follow-Up Studies
;
Fontan Procedure
;
Heart Atria
;
Heart Bypass, Right
;
Humans
;
Infant
;
Medical Records
;
Pulmonary Atresia*
;
Retrospective Studies
;
Survivors
;
Tricuspid Valve
;
Ventricular Septum*
10.Fenestration Operation to Correct Acute Renal Failure After Total Aortic Arch Replacement in DeBakey type I Aortic Dissection: 1 case report.
Seung Hwan PYUN ; Jae Wook NO ; Jung Hee BANG ; Kwang Jo JO ; Chong Su WOO
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(4):402-408
A 56-year old female underwent total aortic arch replacement March 1995, because of an expanding chronic Debakey type I aortic dissection. This aortic dissection had an intimal tear at the origin of the right carotid artery. Retrograde and antegrade propagation of dissection resulted in aortic arch blood flow separation and expanding pseudolumen to the abdominal aorta. Sudden anuria (ARF) developed 3 hours later postoperatively and renal doppler ultrasonography and aortography showed diminished blood flow of renal arteries. We performed balloon aortic dilatation but failed. She could be restored good renal flow after intimal flap fenestration resection and thrombectomy of the abdominal aorta. This patient could be discharged in a state of mild CRF after 2 months of ICU care for respiratory and renal failure.
Acute Kidney Injury*
;
Anuria
;
Aorta, Abdominal
;
Aorta, Thoracic*
;
Aortography
;
Carotid Arteries
;
Dilatation
;
Female
;
Humans
;
Middle Aged
;
Renal Artery
;
Renal Insufficiency
;
Thrombectomy
;
Ultrasonography, Doppler