No abstract available.
Rupture* ; Thorax*

No abstract available.
Mediastinoscopy*

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

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

No abstract available.
Facies*

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

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

BACKGROUND: Many types of tricuspid annuloplasty are used in surgical correction of functional tricuspid regurgitation (FTR). We evaluated the mid-term and long-term outcomes in patients treated with a posterior annular plication technique (a modified Davila technique) for FTR. MATERIAL AND METHOD: Between January 1991 and August 2006, 58 adult patients (male, 22; female, 36) with FTR of grade 2/4 or more or with tricuspid annular dilatation of more than 5.0 cm in diameter, even with an FTR of less than grade 2, had received a posterior annular placation. Preoperatively, 26 patients (44.8%) had a grade 3 or more FTR. All patients had received a mitral valve replacement, and 20 (34.5%) had concomitant aortic valve replacement. RESULT: During the mean follow-up period of 101.4+/-51.6 months, FTR disappeared or remained trivial in 28 patients (49.1%), was grade 2~3 (> or =grade 2 and Adult ; Aortic Valve ; Dilatation ; Female ; Follow-Up Studies ; Humans ; Mitral Valve ; Tricuspid Valve ; Tricuspid Valve Insufficiency

From July 1983 to December 1993, total 112 consecutive mitral valve replacement in 107 patients were performed in patient with mitral valvular abnormalites. To estimate the risk factor related to operative death, all patient's perioperative data were reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age was 37.3+/-13.1 years ranging from 13 to 72 years. Thirty-seven patients were male and fourty-eight patients were female. Mean follow-up durations were 51.1+/-33.8 months ranging from 6 months to 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from 3.02+/-0.73 to 1.78+/-0.55, and also in cardiothoracic ratio, from 0.61+/-0.09 to 0.58+/-0.08 at 6 months follow-up after operation. Operative complications were detected in 23 patients(27.1%) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases. Early mortality was 10.6% ( n=9 ) and most common cause of death was congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period of our mitral surgery was high (5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985 ). Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this study were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation. Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.
Aortic Valve ; Cardiac Output, Low ; Cause of Death ; Female ; Follow-Up Studies ; Freedom ; Heart Failure ; Hemorrhage ; Humans ; Male ; Mitral Valve* ; Mortality ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Risk Factors ; Thromboembolism

Dilated cardiomyopathy, which mostly has an idiopathic etiology or is caused by genetic inheritance or infection, can cause irreversible congestive heart failure. Hypocalcemia is a rare etiology of reversible dilated cardiomyopathy. Here we report the case of a two-month-old girl with congestive heart failure who was diagnosed as having dilated cardiomyopathy secondary to hypocalcemia. After calcium and vitamin D replacement therapy, the patient showed a rapid reduction in hypocalcemic tetany and a rapid recovery of left ventricular function. The cause of the hypocalcemia was vitamin D deficient rickets. She was exclusively breast-fed as an infant, and her mother had a vitamin D deficiency and was diagnosed with osteomalacia.
Calcium ; Cardiomyopathy, Dilated ; Heart Failure ; Humans ; Hypocalcemia ; Infant ; Mothers ; Osteomalacia ; Rickets ; Tetany ; Ventricular Function, Left ; Vitamin D ; Vitamin D Deficiency ; Vitamins ; Wills