A total of 3,119 cardiac valves were replaced in 2,471 patients with acquired valvular heart diseases at Seoul National University Hospital during a period of 26 years from 1968 to 1994. Mechanical valves including St. Jude, Carbomedics, Bjork-Shiley and Duromedics were used in 1,609 cases(52%) and bioprosthetic valves including Lonescu-Shiley, Hancock and Angell Shiley were implanted for the rest of the patients(1,510 cases, 48%). A total of 308(12.5%) redo valve replacement was performed during the same period, and 10 of 308 patients underwent second redo valve replacements. The single valve replacement was done in 1,846 cases, double valve replacement in 602 cases and triple valve replacement in 23 cases. Among the single valve replacement, the mitral valve replacement was performed most frequently(1,377 cases). The male to female ratio was almost equal(1.223 : 1,248) and the mean age was 37.9+/-10.5 years old. But the mean age has been increasing year by year and it reached to 44.8 years old in the 1990's. The overall hospital mortality was 5.3%, and 6.8% in redo valve replacement. However, the hospital mortality for the recent 10 years dropped to 1 to 4%. The number of redo valve surgery has been increasing since the mid-1980's because of structural deterioration of bioprostheses that were replaced during the late-1970's and early 1980's. Redo valve surgery comprised 34% for all valve replacement in 1994. The causes of the redo valve operation were structural deterioration(81.5%), prosthetic valve endocarditis(11.7%), paravalvular leakage(5.6%), and valve thrombosis(0.9%). The actuarial freedom from overall valve failure in Ionescu-Shiley were 81.0+/-7.1%(5 year) in mitral position, 89.1+/-1.8%(7 year) in aortic position and 88.9+/-7.6% in double valve replacement. The 5 year actuarial freedom from all complications in Carbomedics were 90.1+/-3.1% in mitral position, 84.9+/-4.2% in aortic position and 81.7+/-5.1% in double valve replacement. The 10 year actuarial freedom from all complications in St. Jude were 80.9+/-3.8%, 81.4+/-6.1%, 72.4+/-10.7% in each positions. In conclusion, the mean age of patients was younger than that of western countries, but it showed increasing tendency year by year. Bioprosthetic valves were used during the initial period until mid-1980's when mechanical valves were used instead of bioprosthetic valves, mainly because of the structural deterioration of the bioprostheses. In terms of thromboembolism, both bioprostheses and mechanical valves seems to be almost comparable although the comparison of both valves was impossible because of the different period of operation, various surgeon and level of the prothrombin time and so on. Recently the number of valve replacement has been decreased since the 1990's and the number of redo valve surgery and valve repair has been increased.
Bioprosthesis ; Female ; Freedom ; Heart Valve Diseases ; Heart Valves* ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Prothrombin Time ; Seoul* ; Thromboembolism

No abstract available.

Over the past four decades after Korean War, a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of cardiovascular diseases. Among many institutes, Seoul National University Hospital Including Children's Hospital has played a leading role up to date. Clinical data following the first open heart surgery on August 7,1959 up to December 1993 revealed that the total number of open heart surgery was cises in Seoul National University Hospital and overall mortality was 6.8%. Since 1977, the cases of open heart surgery has rapidly increased due to two main reasons : Accumulation of untreated cardiac patients and widening coverage by national medical insurance. The number of cases exceeded 100 in 1978, 400 in 1980, 600 in 1982 and 700 in 1986. In the second half of 1980's and 1990's the number of cases were over 700 per year. The ratio of congenital to acquired heat disease was 1.5:1 , and that of acyanotic to cyanotic congenital cardiac anomaly was 2.0: 1. The order of frequency of acyanotic group was Ventricular Septal Defect(56.4%), Atrial Septal Defect(28.6%), Endocardial Cushion Defect(4.6%), Pulmonary Stenosis(2.9%) and Patent Ductus Arteriosus(1.0%). Whereas the incidence of cyanotic group was Tetralogy of Fallot(57.5%), Transpotion of Great Arteries(9.5%),Double Outlet Right Ventricle(8.7%) and Pulmonary Atresia(5.7%). The overall mortality of acyanotic congenital heart disease was 2.9% and that of cyanotic congenital heart disease was 16.7%. Transposition of Great Arteries, Pulmonary Atresia and Truncus Arteriosus especially resulted in very high mortality,25-30%. The causes of high mortality in these group were inadequate patient selection for operation, inexperienced perioperative neonatal care and unskiled operative technique, but the figure was remarkebly improved since 1990, and now operative mortality reached under 10%. In 2019 cased of valvular heart disease, single mitral valve disease was most common (1139 cases) and double valvular disease was 534 cases and triple valvular disease was 41 cases. According to the order of frequency in redo valvular disease was 6,0%. The frequency of ischemic heart disease and aortic disease were not so frequency previously but these figures rapidly increase in recent days. The first CABG was performed at this hospital in 1981 and 240 cases have been performed by 1993.Overall mortality was 7.1%. The number of cases in 1993 was increased two times compared to 1992, but the mortality was decreased to 2.4%. Acute aortic dissection (57 cases) was most common among 127 cases of aortic disease which was operative mortality was 26.3% which was very high. Mortality gradually decreased recently down to zero because of appropriate brain protection technique including deep hypothemia, circulatory arrest and selective cerebral perfusion. In Korea, brain death is not accepted by law as well as traditional concept. However in 1993 and up to now, five cases of heart transplantation were performed by voluntary consent of familly of the donor and recipient.
Academies and Institutes ; Aortic Diseases ; Brain ; Brain Death ; Cardiovascular Diseases ; Diagnosis ; Endocardial Cushions ; Heart Defects, Congenital ; Heart Transplantation ; Heart Valve Diseases ; Heart* ; Hot Temperature ; Humans ; Incidence ; Insurance ; Jurisprudence ; Korea ; Korean War ; Mitral Valve ; Mortality ; Myocardial Ischemia ; Patient Selection ; Perfusion ; Pulmonary Atresia ; Seoul ; Thoracic Surgery* ; Tissue Donors ; Transposition of Great Vessels ; Truncus Arteriosus

Over the past four decades after Korean War, a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of cardiovascular diseases. Among many institutes, Seoul National University Hospital Including Children's Hospital has played a leading role up to date. Clinical data following the first open heart surgery on August 7,1959 up to December 1993 revealed that the total number of open heart surgery was cises in Seoul National University Hospital and overall mortality was 6.8%. Since 1977, the cases of open heart surgery has rapidly increased due to two main reasons : Accumulation of untreated cardiac patients and widening coverage by national medical insurance. The number of cases exceeded 100 in 1978, 400 in 1980, 600 in 1982 and 700 in 1986. In the second half of 1980's and 1990's the number of cases were over 700 per year. The ratio of congenital to acquired heat disease was 1.5:1 , and that of acyanotic to cyanotic congenital cardiac anomaly was 2.0: 1. The order of frequency of acyanotic group was Ventricular Septal Defect(56.4%), Atrial Septal Defect(28.6%), Endocardial Cushion Defect(4.6%), Pulmonary Stenosis(2.9%) and Patent Ductus Arteriosus(1.0%). Whereas the incidence of cyanotic group was Tetralogy of Fallot(57.5%), Transpotion of Great Arteries(9.5%),Double Outlet Right Ventricle(8.7%) and Pulmonary Atresia(5.7%). The overall mortality of acyanotic congenital heart disease was 2.9% and that of cyanotic congenital heart disease was 16.7%. Transposition of Great Arteries, Pulmonary Atresia and Truncus Arteriosus especially resulted in very high mortality,25-30%. The causes of high mortality in these group were inadequate patient selection for operation, inexperienced perioperative neonatal care and unskiled operative technique, but the figure was remarkebly improved since 1990, and now operative mortality reached under 10%. In 2019 cased of valvular heart disease, single mitral valve disease was most common (1139 cases) and double valvular disease was 534 cases and triple valvular disease was 41 cases. According to the order of frequency in redo valvular disease was 6,0%. The frequency of ischemic heart disease and aortic disease were not so frequency previously but these figures rapidly increase in recent days. The first CABG was performed at this hospital in 1981 and 240 cases have been performed by 1993.Overall mortality was 7.1%. The number of cases in 1993 was increased two times compared to 1992, but the mortality was decreased to 2.4%. Acute aortic dissection (57 cases) was most common among 127 cases of aortic disease which was operative mortality was 26.3% which was very high. Mortality gradually decreased recently down to zero because of appropriate brain protection technique including deep hypothemia, circulatory arrest and selective cerebral perfusion. In Korea, brain death is not accepted by law as well as traditional concept. However in 1993 and up to now, five cases of heart transplantation were performed by voluntary consent of familly of the donor and recipient.
Academies and Institutes ; Aortic Diseases ; Brain ; Brain Death ; Cardiovascular Diseases ; Diagnosis ; Endocardial Cushions ; Heart Defects, Congenital ; Heart Transplantation ; Heart Valve Diseases ; Heart* ; Hot Temperature ; Humans ; Incidence ; Insurance ; Jurisprudence ; Korea ; Korean War ; Mitral Valve ; Mortality ; Myocardial Ischemia ; Patient Selection ; Perfusion ; Pulmonary Atresia ; Seoul ; Thoracic Surgery* ; Tissue Donors ; Transposition of Great Vessels ; Truncus Arteriosus

No abstract available.
Orbit*

No abstract available.
Humans ; Microsporum* ; Siblings* ; Tinea Capitis* ; Tinea*

No abstract available.
Humans ; Infant* ; Male* ; Urticaria Pigmentosa* ; Urticaria*

No abstract available.
Perfusion* ; Transplants*

No abstract available.
Acute Kidney Injury* ; Cardiopulmonary Bypass* ; Renal Replacement Therapy*

BACKGROUND: Onychomycosis is one of the most prevalent fungal diseases in the general population. However, treatment is of limited effectiveness and must be administered for long periods of time. Systemic antifungal agents are associated with adverse effects. OBJECTIVE: We evaluated the clinical efficacy and safety of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with amorolfine nail lacquer to treat onychomycosis. METHODS: The 128 patients were randomly divided to 2 groups: 64 in the experimental group were treated with 1,064-nm Nd:YAG laser therapy and amorolfine nail lacquer; the other 64 were in a control group treated with topical amorolfine lacquer monotherapy. The laser treatment was 4 sessions at 4-week intervals and amorolfine lacquer was applied once a week for 16 weeks. Efficacy was assessed as response rate from standardized photographs with ImagePro®Plus (Media Cybernetics, Inc., USA) analysis, microscopic examination, and subjective evaluation. RESULTS: At 16 weeks, the experimental group showed a significantly higher cumulative cure rate than the control group (71.88% vs. 20.31%, p<0.0001). Clinical therapeutic effects were linked to patient satisfaction. The percent of “very satisfied” or “satisfied” responses was higher in the test group than the control group (81.25% vs. 23.44%). The treatment regimen was well tolerated, with transient discomfort observed in the test group. CONCLUSION: The 1,064-nm Nd:YAG laser with amorolfine nail lacquer was effective and safe for treating onychomycosis. This therapy should be considered an alternative treatment, especially for patients with contraindications to systemic antifungal agents.
Antifungal Agents ; Cybernetics ; Humans ; Lacquer* ; Laser Therapy ; Onychomycosis* ; Patient Satisfaction ; Therapeutic Uses ; Treatment Outcome ; Yttrium*