Pulmonic autograft replacement of the aortic valve (Ross procedure) has been to have potential for growth in children, no complication of antiocagulation, and enhanced durability. Therefore, Ross operation is indicated in the young, in patients with an active life style, and when anticoagulation is contraindicated. However, late autograft valve has occurrd more frequently in patients with significant size discrepancy between the pulmonay valve annulus and the aortic valve annulus. In order to resolve this problem, we performed aortic annuloplasty with Duran ring for more accurate and strong reinforcement. We report a case using the Duran ring as a method of aortic annuloplasty during Ross procedure.
Aortic Valve ; Autografts ; Child ; Humans ; Life Style

Primary teratomas of bladder are exceedingly rare, it can be easily diagnosed by characteristic symptom, cystoscopy, and X-ray and it can be managed by locally removal of tumor or partial cystectomy. A case of primary teratoma of bladder in a 38 years old woman is presented. The patient was managed by transurethral resection of bladder tumor and followed up for 5 years without recurrence.
Adult ; Cystectomy ; Cystoscopy ; Female ; Humans ; Recurrence ; Teratoma* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Intrabronchial nerilemmoma is very rare disease. Neurilemmoma has been thought to arise from schwann cell, has been reported to occur in almost any anatomic location. The incidence of primary neurogenic tumors of the lung has been estimated to be 0 to 2 percent of all lung tumors. These tumors are predominantly(75%) associated with neurofibromatosis of von Recklinghausen's disease. To our knowledge, no case of benign solitary endobronchial neurilemmoma has been reported in Korea. This paper presents a case of benign solitary endobronchial neurilemmoma with a brief review of the pertinent literature. A 19 year old female visited our medical hospital with the symptoms of chest discomfort and pain. Bronchoscopy and chest CT scan revealed a mass on the left upper 1obar bronchus. Left upper lobectomy was performed successfully and histological section revealed a neurilemmoma.
Bronchi ; Bronchoscopy ; Female ; Humans ; Incidence ; Korea ; Lung ; Neurilemmoma* ; Neurofibromatoses ; Neurofibromatosis 1 ; Rare Diseases ; Thorax ; Tomography, X-Ray Computed ; Young Adult

Central anticholinergic syndrome is defined as an absolute or relative reduction in cholinergic activity in the central nervous system and has a wide variety of manifestations. It is associated with almost any drug given during anesthesia, except neuromuscular relaxants, and treated with the cholinesterase inhibitor physostigmine. The diagnosis of central anticholinergic syndrome is often made when symptoms resolve promptly after the administration of physostigmine. We present a case of a central anticholinergic syndrome diagnosed by treatment with physostigmine, in a patient who received closure of patent foramen ovale associated with stroke.
Anesthesia ; Anticholinergic Syndrome* ; Central Nervous System ; Cholinesterases ; Diagnosis ; Foramen Ovale, Patent ; Humans ; Physostigmine ; Stroke

We described a 65-year-old female of 45,X/46,XX Turner's syndrome associated with patent ductus arteriosus who was admitted due to exertional dyspnea and palpitation. This patient had not spontaneous mensturation and had a short stature without webbed neck and a sexual infantilism. Chromosomal aberrations cause primarily structural defects of cardiovascular system, and a variety of structural aberrations involving the X chromosome can cause partial or complete Turner's syndrome. In Turner's syndrome, bicuspid aortic valve or coarctation of aorta is frequently combined, also aortic root dilatation, partial anomalous venous drainage, hypoplastic left heart, ventricular septal defect, atrial septal defect has been reported. However, this patient had not abnormality in aortic valve and whole aorta. Patent ductus arteriosus in 45,X/46,XX Turner's syndrome have not been reported in Korea. We report this case with a brief review of the literature.
Aged ; Aorta ; Aortic Coarctation ; Aortic Valve ; Bicuspid ; Cardiovascular System ; Chromosome Aberrations ; Dilatation ; Drainage ; Ductus Arteriosus, Patent* ; Dyspnea ; Female ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Korea ; Neck ; Sexual Infantilism ; Turner Syndrome ; X Chromosome

We descrive a 23-year-old female of 46, XXqi Turner's syndrome associated with large atrial sepatal defect(secundum type) and mitral valve prolapse who was admitted due to amenorrhea, sexual infantilism and exertional dyspnea. This patient had only one spontaneous menstrual period at the age of 15 and had a short stature without webbed neck. Chromosomal aberrations cause primarily structural defects of cardiovasculaqr system, and a variety of structural aberrations involving the X chromosome and cause partial or complete Turner's syndrome. In Turner's syndrome, bicuspid aortic valve or coarctaton of aorta is frequently combined, also aortic root dilatation, partial anomalous venous drainage, hypoplastic left heart and ventricular septal defect, atrial septal defect has been reported. However, this patient had not abnormalities in aortic valve and whole aorta. Atrial septal defect simultaneously with mitral valve prolapse in 46 XXqi Turner's syndrome have not been reported in Korea. We report this case with a brief review of the literature.
Amenorrhea ; Aorta ; Aortic Valve ; Bicuspid ; Chromosome Aberrations ; Dilatation ; Drainage ; Dyspnea ; Female ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Korea ; Mitral Valve Prolapse ; Mitral Valve ; Neck ; Sexual Infantilism ; Turner Syndrome ; X Chromosome ; Young Adult

BACKGROUND AND OBJECTIVES: Although it is well known that postoperative left ventricular contractile function is an important prognostic factor in mitral regurgitation, temporal changes of left ventricular contractile function could not be evaluated due to lack of follow-up studies and the difference according to the type of surgery was not established. We addressed these issues by analyzing the data of serial echocardiographic studies and sought to determine factors associated with mortality and cardiovascular events during follow-up. MATERIALS AND METHOD: Retrospective analysis of echocardiographic data and medical records was done in patients who underwent corrective surgery for significant mitral regurgitation at the Asan Medical Center from January 1990 to December 1997. Patients who underwent echocardiography before and immediately after the surgery, and follow-up study at least 6 months later were selected for the analysis. RESULTS: Of 199 patients who underwent mitral valve surgery for mitral regurgitation during that period, 164 patients were included in this study. Among them, 89 patients underwent valve repair and 75 valve replacement. Immediately after surgery, ejection fraction decreased significantly in all patients (62+/-9% vs. 50+/-10%, p<0.01). At the average of 32 months after surgery, ejection fraction was significantly higher in the repair group than in the replacement group (57+/-10% vs. 52+/-11%, p=0.01). During follow-up (mean 32+/-24 months), there were 53 cardiovascular events in 33 patients (heart failure in 14, cardiac death in 11, stroke in 11, reoperation in 11, hemorrhage in 4, thromboembolism in 1 and endocarditis in 1). Cardiovascular events were significantly more frequent in valve replacement group than in valve repair group (23/75 vs. 10/89, p=0.002). Multivariate analysis showed that the independent predictors of all cardiovascular events were immediate postoperative end-systolic volume (p=0.006, hazard risk=1.026, 95% CI=1.01~1.05) and age (p=0.04, hazard risk=1.07, 95% CI=1.001-1.14). The overall survival rate was 85+/-6% at 7 years. Multivariate analysis revealed an independent beneficial effect of valve repair on overall survival (p=0.0058, hazard ratio=0.046, 95% CI=0.005-0.411). CONCLUSION: After surgery, ejection fraction decreased significantly in both groups. However, patients with repair showed progressive improvement of left ventricular contractility and revealed higher ejection fraction at the follow-up study than those with replacement, which might contribute to higher survival rate in this group.
Chungcheongnam-do ; Death ; Echocardiography ; Endocarditis ; Follow-Up Studies ; Hemorrhage ; Humans ; Medical Records ; Mitral Valve ; Mitral Valve Insufficiency* ; Mortality ; Multivariate Analysis ; Reoperation ; Retrospective Studies ; Stroke ; Survival Rate ; Thromboembolism ; Ventricular Function, Left