No abstract available.
Mediastinoscopy*

No abstract available.
Rupture* ; Thorax*

BACKGROUND: A pleural effusion is not a disease entity but a clincial sign of systemic or pleural disease. Although the diagnosis of pleural effusion can often be done by toracentesis and pleural needle biopsy the yeild of positive diagnosis is low.
Biopsy, Needle ; Diagnosis ; Pleural Diseases ; Pleural Effusion* ; Thoracoscopy*

BACKGROUND: Mitral valve replacement(MVR) with chordal preservation in patients with mitral vlavular disease has been proven to be beneficial for left ventricular function and for reduction of postoperative complication. MATERIAL AND METHOD: From January 1995 to July 1996, the early postoperative results of mitral valve replacement were compared between 20 patients who underwent chordae resection(classic MVR group) and 10 patients who underwent chordae preservation(preservation MVR group) in the Department of Thoracic and Cardiovascular Surgery, Chunbuk National University Hospital. RESULT: There was no significant difference between the two groups in age, sex, NYHA functional class, cardiothoracic ratio, echocardiographic finding, cardiopulmonary bypass time and aortic cross clamping time. The difference between preoperative and postoperative cardiothoracic ratio after 3 months was not statistically significant. At echocardiographic left ventricular evaluation, ejection fraction and fractional shortening decreased slightly in the preservation group then preoperative value (p=0.47, p=0.12), however, decreased significantly in the classic MVR group(p=0.03, p=0.04), and were statistically significant between the two groups(p=0.03, p=0.02). CONCLUSION: We conclude that MVR with chorda preservation seems to have a beneficial effect on postoperative left ventricular performance in mitral valve disease than the classic MVR.
Cardiopulmonary Bypass ; Constriction ; Echocardiography ; Humans ; Mitral Valve* ; Postoperative Complications ; Ventricular Function, Left

BACKGROUND: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75+/-9.74 years) RESULT: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06+/-10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombombolism free rate at 36 months were 96.9% and 98.4% respectively. CONCLUSIONS: The CarboMedics valve stands for low valve related complicatons.
Carbon ; Cardiac Output, Low ; Cause of Death ; Embolism ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Hemorrhage ; Mortality ; Polyethylene Terephthalates ; Thrombosis

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

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

Unilateral renal agenesis associated with genito-urinary disease was found in 2 siblings of a single family. There are a few reports of familial unilateral renal agenesis. Bilateral renal agenesis is a fetal condition and unilateral renal agenesis or hypoplasia is usually asymptomatic, so investigations for renal anomalies have not been frequently undertaken in healthy members of families in which bilateral agenesis has occurred. The present report suggests that unilateral renal agenesis could occur as a manifestation of a genetic disorder.
Humans ; Kidney Diseases ; Siblings*

BACKGROUND: Cardiac atrium is an endocrine gland secreting a family of natriuretic peptides. The secretion of atrial natriuretic peptide(ANP) had been shown to be controlled by variable factors. The change in atrial dynamics have been considered as one of the most prominent stimuli for the stimulation of ANP secretion. Hypoxic stress has been shown to increase cardiac ANP secretion. However, the mechanism by which hypoxia increases ANP secretion cardiac ANP secretions. However, the mechanism by which hypoxia increases ANP secretion has not to be defined. Therefore, the purpose of the present study was tow-fold: to develop a protocol to defined the effect of hypoxia on ANP secretion in perfused beating rabbit atria and to clarify the mechanism responsible for the accentuation by hypoxia of ANP secretion. MATERIAL AND METHOD: Experiments have been done in perfused beating rabbit atria. ANP was measured by radioimmunoassay. RESULT: Hypoxic stimulus with nitrogen decreased atrial stroke volume. The decrease in atrial stroke volume recovered basal level during the period of recovery with oxygen. ANP secretion and the concentration of perfusate ANP in terms of extracellular fluid(ECF) translocation which reflects the rate of myocytic release of ANP were increased by hypoxia and returned to basal levels during the recovery. Changes in ECF translocation paralleled by hypoxia and returned to basal levels during the recovery. Changes in ECF translocation paralleled to that of atrial stroke volume. At the start of recovery in atrial storke volume, ECF tranalocation incrased for several minutes. The above responses were stable and reproducible. Glibenclamide treatment prevented the recovery in atrial stroke volume. Increments by hypoxia of ANP secretion and ANP concentration were suppressed by glibenclamide. CONCLUSIONS: These results indicate that hypoxia incrased atrial myocytic ANP release and that the mechanism responsible for the accentuation is partially related to the change in K+ATP channel activity.
Anoxia ; Atrial Natriuretic Factor* ; Endocrine Glands ; Glyburide ; Heart Atria ; Humans ; Natriuretic Peptides ; Nitrogen ; Oxygen ; Radioimmunoassay ; Stroke Volume

BACKGROUND: The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral vlave disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). MATERIAL AND METHOD: From March 1991 to March 2001, 38 patients underwent mitral vlave repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6+/-14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. RESULT: According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type I, 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1,3,51,69,84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. CONCLUSION: In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.
Cause of Death ; Classification ; Constriction, Pathologic ; Female ; Humans ; Male ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Papillary Muscles ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis