No abstract available.
Mediastinoscopy*

No abstract available.
Rupture* ; Thorax*

OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

Recently, primary lung cancer has increased markedly in incidence and prevalence in korea. From July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:F=8.6:1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asympto- matic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveolar cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, segmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage II 14.8%, stage III a 31.1%, and stage III b 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage I 53.0%, stage II 46.5%, stage III a 28.2%, and stage III b 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were N1 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3%(p>0.05).
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Hemoptysis ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Male ; Mastectomy, Segmental ; Mortality ; Pneumonectomy ; Postoperative Complications ; Prevalence ; Survival Rate ; Thorax ; Tolnaftate

No abstract available.
Facies*

BACKGROUND: For resection of esophageal cancer, esophagogastrostomy caused serous multiple complications such as leakage of anastomosis site, stenosis, recurrence of cancer, etc. Especially, accoding to the anastomosis site of esophagogastrostomy, patients in post operation state was felt various subjective symptom, multiple complications and longer hospital periods, etc. Therefore, there was a demand for comparison and analysis of complication between cervical and thoracic esophagogastrostomy. MATERIAL AND METHOD: From January 1995 to May 1999, 55patients with esophageal cancer underwent cervical esophagogastrostomy(23patients) or thoracic esophagogastrostomy(32patients). Cancer was grouped according to the postoperative staging(I--5pt, II--27pt, III--23pt) by the AJCC classification and location: upper thoracic(3pt), middle(34pt) and lower(18pt). Cancer was mostly squamous cell carcinoma except 2 adenocarcinoma. Fifty five patients were male with average age of 59 years for cervical anastomosis and 55 years for thoracic anastomosis. The staple anastomosis was done in one cervical anastomosis patient and 23 thoracic anastomosis patients. RESULT: There was one mortality from cervical anastomosis and two from thoracic anastomosis. Fourty six complications(respiratory and digestive system, etc..) occurred in 15cervical anastomosis patients and 37 complication in 13thoracic anastomosis patients. In 23cervical esophagogastrostomy patients, 11patients had moderate to severe dysphagea during swallowing. However, only 2thoracic anastomosis patients experienced this dysphagea. The postoperative hospital stay was above 20days in 18 cervical anastomosis patients, and in 13thoracic anastomosis patients. CONCLUSION: Among esophageal tumor cases, respiratory, digestive, infection and other complications did occur after esophagogastric anastomosis. Particularly, mortality rate secondary to respiratory complication was high. Anastomotic leakage was more frequent in manual anastomosis than in staple anastomosis, and was also seen more frequently among cervical anastomosis than among thoracic anastomosis. In the cases of cervical anastomosis, the patients complained more of dysphagea while their hospital stays were significantly long.
Acyclovir* ; Adenocarcinoma ; Anastomotic Leak ; Carcinoma, Squamous Cell ; Classification ; Constriction, Pathologic ; Deglutition ; Digestive System ; Esophageal Neoplasms* ; Humans ; Length of Stay ; Male ; Mortality ; Postoperative Complications ; Recurrence

The Bentall-DeBono operation is the technique of choice for aortic root replacement. When the patients have contraindications for lifelong anticoagulation, the biologic Bentall operation may be a good option. However, complex reoperation may be required when bioprosthetic degeneration occurs. For this reason, a new technique for simple reoperation after the Bentall operation has recently been performed by some surgeons. We performed a similar technique in two patients with aortic root dilation and for whom aortic valve sparing techniques could not be performed because of an unrepairable valve contour, we think this modification seems to be simple and reproducible for reoperation.
Aneurysm ; Aorta ; Aortic Valve ; Bioprosthesis ; Cardiovascular Diseases ; Humans ; Reoperation

Patients with concomitant surgical diseases of the heart and lungs are a therapeutic challenge to cardiothoracic surgeons. A 59-year-old woman underwent right middle lobectomy for lung cancer and redo double valve replacement with tricuspid annuloplasty simultaneously. Concomitant operation is a safe procedure and might allow prompt correction of both conditions, thereby sparing the patient a second major thoracic procedure with its attendant risks.
Female ; Heart ; Heart Valve Diseases ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Thoracic Surgery

To evaluate a new reliable sclerosant of the gallbladder, we attempted gallbladder ablation with 10% phenol, and the results compared with those from using 95% ethanol which had been used previousy as gallbladder sclerosing agent in laboratory animals in other reports. After laparotomy, ligation of the cystic dusts with silk and cannulation of gallbladder with 18 gauge angiocatheter were done. Then, transcatheter administration of two different scleroing agents was performed in 8 rabbits respectively and normal saline in four rabbits as a control. Additionally, preliminary washing with each agent were implemented to prevent the dilutional effect of residual bile and bleeding. All animals survived without complication. Eight animals were used for each agent, four each being sacrified two weeks and six weeks after adminstration of sclerosing agents respectively. In our results, 10% phenol was more effective than 95% ethanol in denuding the gallbladder epithelium and promoting fibrosis of gallbladder wall, And it was relatively safe in regard to the dilutional effect of residual fluid and bleeding during procedure. Toxic effects on the liver evaluated by examination of histologic specimen were non-specific except for edematous swelling on some cases, which had also been observed on others including control group. 10% phenol can be considered to be a promosing sclerosant for gallbladder ablation, but further study of its toxicity is needed before its application on human gallbladder.
Animals ; Animals, Laboratory ; Bile ; Catheterization ; Dust ; Epithelium ; Ethanol ; Fibrosis ; Gallbladder* ; Hemorrhage ; Humans ; Laparotomy ; Ligation ; Liver ; Phenol* ; Rabbits* ; Sclerosing Solutions ; Sclerosis* ; Silk

BACKGROUND: A retrospective study was conducted to analyze the results of St. Jude Medical mitral valve replacement at the Chonbuk National University Hospital since the initial implant in May 1984. MATERIAL AND METHOD: Between May of 1984 and December of 1996, 95 patients underwent MVR with the St. Jude Medical mechanical valve prosthesis at Department of Medical Science of Chonbuk National University Hospital and follow-up ended in May of 2004. RESULT: Age ranged from 19 to 69 years. Follow-up (mean+/-standard deviation) averaged 10.6+/-4.2 year. Thirty-day operative mortality was 4.2% (4/95). Nine late deaths have occurred and actuarial survival was 90.5+/-3.0%, 87.9+/-3.4% and 83.2+/-4.6% at 5, 10 and 20 years, respectively. Probability of freedom from valve-related death was 95.5+/-2.1%, 94.3+/-2.4% and 91.0+/-3.9% at 5, 10 and 20 years, respectively. Seven patients have sustained thromboembolic events (1.05%/patient-year). Fifteen patients had anticoagulation related hemorrhage (3.56%/patient-year). There was no structural valve deterioration. Probability of freedom from all complications was 82.0+/-3.9%, 71.3+/-4.8% and 42.4+/-10.5% at 5, 10 and 20 years, respectively. CONCLUSION: We confirm the effective and excellent durability of the St. Jude Medical prosthesis in the mitral position with a low event rate at long-term follow-up. It also demonstrates the commonly encountered practical difficulty of adjusting the anticoagulation protocol in patients with prosthetic mitral valves.
Follow-Up Studies ; Freedom ; Heart Valve Diseases ; Heart Valve Prosthesis ; Hemorrhage ; Humans ; Jeollabuk-do ; Mitral Valve* ; Mortality ; Prostheses and Implants* ; Retrospective Studies