Minimally invasive surgery is now rapidly developing and becoming a standard surgical option in some fields. In the past, many thoracic surgeons were reluctant to adopt minimally invasive techniques in esophageal cancer surgery due to concern over the oncologic perspectives and technical difficulties. However, over the last few years, thoracic surgeons have progressively embraced the technical advancements and now many experienced centers have adopt minimally invasive surgery as a primary option for non-advanced esophageal cancer operations. In esophageal cancer surgery, the volume of operation performed in some hospital is closely related to the outcome of patients, and the experiences of surgical team play an important role in minimally invasive surgery. Minimally invasive esophageal surgery (MIES) has steep learning curves, also. The merits of MIES are as follows. The conventional esophageal cancer operation has two or triple incisions, resulting in high postoperative morbidity and mortality. However, postoperative complication in MIES became less frequent than conventional surgery. The patient's satisfaction is high. Mid-term outcomes of MIES have been reported that it is safe and feasible in esophageal cancer and survival curves are similar to those of conventional surgery. Therefore, MIES is a valuable therapeutic modality for both esophageal cancer patients and thoracic surgeons.
Esophageal Neoplasms/*surgery ; Humans ; Laparoscopy/methods ; Surgical Procedures, Minimally Invasive/methods ; Thoracoscopy/methods

For the evaluation of exercise induced R wave amplitude changes in lead V5 (big up tri, openR) and multiple leads(summation operatorR), we studied 20 normal subjects and 21 ischemic heart disease patients with positive exercise test. All underwent submaximal, multiple leads multistage treadmill exercise testing. 14 to 20 normal subjects(70%) there were decreased R wave amplitude in multiple leads on treadmill exercise testing. 16 of 21 patients(76%) there were increased R wave amplitude on treadmill exercise testing. In normal group, R wave amplitude between rest and exercise was significantly decreased in lead V5 and multiple leads. In patients grous, R wave amplitude between rest and exercise was significantly increased in lead V5 and multiple leads. It is suggested exercise induced R wave amplitude changes probably enhance the diagnostic reliability by ST segment changes on treadmill exercise testing.
Exercise Test* ; Humans ; Myocardial Ischemia

OBJECTIVE: To evaluate Fragile histidine triad (Fhit) and p53 expression pattern in cervical intraepithelial neoplasm (CIN) and invasive cervical cancer, and to verify the correlation between the loss of Fhit and clinicopathological parameters of invasive cervical carcinoma and the relationship between Fhit and p53 expression. METHODS: 10 low-grade squamous intraepithelial lesions (LSIL), 16 high-grade squamous intraepithelial lesions (HSIL), and 21 invasive cervical carcinomas were evaluated by immunohistochemical staining for Fhit and p53 primary antibody. Their expression patterns in CIN and invasive cervical cancer were analysed semiquantitatively as positive and negative by the staining area and intensity. Clinicopathological data were obtained by review of patients' hospital records. RESULTS: Compared with CIN (LSIL and HSIL), invasive cervical carcinoma showed significantly loss of Fhit expression (p<0.05). P53 expression did not show the significant difference between CIN and invasive cervical cancer. There was no relationship between loss of Fhit and p53 expression in CIN and invasive cervical cancer. But loss of Fhit expression in invasive cervical cancer was also significantly associated with FIGO stage (p<0.05). CONCLUSION: Our results suggest that loss of Fhit expression may play an important role in the malignant transformation of CIN to invasive cancer. However, further molecular studies are needed to elucidate the role of Fhit gene in the carcinogenesis of cervical cancer.
Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Histidine ; Hospital Records ; Uterine Cervical Neoplasms*

This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07+/-11.76 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median sternotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta and/or partial or total aortic arch were performed in 9 patients, descending aorta and/or thoracoabdominal aorta in 3 and total aorta in 1. Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta and/or aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67+/-29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in 1.
Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic* ; Aortic Valve ; Bile ; Elephants ; Female ; Hemorrhage ; Humans ; Hypertension, Malignant ; Hypothermia ; Jeollanam-do ; Male ; Perfusion ; Pericardial Effusion ; Peritonitis ; Postoperative Complications ; Reoperation ; Replantation ; Rupture ; Sternotomy ; Thoracotomy ; Transplants

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

Hyperglycemic state frequently presents with neurologic manifestations including choreoathetosis, ballismus, dysphagia, seizures, and coma. Also, hyperglycemic hemianopia has been rarely reported to cause temporary damage to the visual cortex, resulting in homonymous hemianopia. A 65-year-old man was admitted because of right homonymous hemianopia accompanied by hyperglycemia. Brain single-photon emission computed tomography showed focal hyperperfusion in the left occipital lobe. Herein we report a case of reversible homonymous hemianopia with cerebral hyperperfusion associated hyperglycemia without seizure.

Congenital cystic adenomatoid malformation of the lung is a rare pulmonary malformation, Although it is one of the most common congenital anomalies which cause acute respiratory distress in the newborn infants, characterized by marked proliferation of terminal respiratory structures. We have experienced an unusual case of congenital cystic adenomatoid malformation associated with pectus excavatum. The patient was 3-year-old female who suffered from cough and high fever for 20 days, and antibiotic therapy was given in other hospital before transfer to our hospital. The findings on chest X-ray, chest CT, aortogram, and selective bronchial arteriogram showed cystic lesions in the right upper and middle lobe accompanied but severe pectus excavatum. Right bilobectomy for pulmonary lesion and costosternal elevation for pectus excavatum was performed simultaneously with successful result. The postoperative course was uneventful and the patient was discharged on the twentieth postoperative day.
Child, Preschool ; Cough ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Female ; Fever ; Funnel Chest* ; Humans ; Infant, Newborn ; Lung ; Thorax ; Tomography, X-Ray Computed

Pseudoaneurysm of the thoracic aorta is potentially fatal. However, reports of such cases are rare even in large series. We report four csaes of thoracic aortic pseudoaneurysm who underwent surgical repair. The causes were considered as infection in two cases (VSD repair, descending thoracic aortic aneurysm resection) and blunt chest trauma by traffic accident in two patients. The pseudoaneurysms developed on ascending aorta suspected as sites of arterial and cardiolplegic needle insertion in one patient. The others were located at descending thoracic aorta immediatly below the left subclavian artery. One patient died of sepsis associated with bile peritonitis and others were followed up from 10 to 18 months with specific morbidity. This study suggest that the incidence of pseudoaneurysm of the thoracic aorta followed by open heart or aorctic surgery can be repaired succesfuly and careful inspection of associated injury is very important in cases of traumatic thoracic pseudoaneurysm.
Accidents, Traffic ; Aneurysm, False* ; Aorta ; Aorta, Thoracic* ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Bile ; Heart ; Humans ; Incidence ; Needles ; Peritonitis ; Sepsis ; Subclavian Artery ; Thorax

Cardiac rhabdomyomas are the most common primary tumor in infancy and childhood and are frequently associated with tuberous sclerosis. Although spontaneous regression of cardiac rhabdomyoma has been reported , prognosis of this tumor associated with subaortic stenosis is still considered to be poor and surgery continues to be indicated. A 4-day-old female was admitted due to tachypnea and cyanosis. Single rhabdomyoma arising from the interventricular septum associated with severe subaortic stenosis was partially removed under cardiopulmonary bypass. Excised tumor size was 0.7 X 0.9 X 0.4 cm in dimension. The postoperative course was uneventful and the infant discharged on the 14th postoperative day.
Cardiopulmonary Bypass ; Constriction, Pathologic ; Cyanosis ; Echocardiography ; Female ; Heart Neoplasms ; Humans ; Infant ; Infant, Newborn* ; Prognosis ; Rhabdomyoma* ; Tachypnea ; Tuberous Sclerosis ; Ventricular Outflow Obstruction*

Congenital cystic adenomatoid malformation of the lung is a rare pulmonary malformation, Although it is one of the most common congenital anomalies which cause acute respiratory distress in the newborn infants, characterized by marked proliferation of terminal respiratory structures. We have experienced an unusual case of congenital cystic adenomatoid malformation associated with pectus excavatum. The patient was 3-year-old female who suffered from cough and high fever for 20 days, and antibiotic therapy was given in other hospital before transfer to our hospital. The findings on chest X-ray, chest CT, aortogram, and selective bronchial arteriogram showed cystic lesions in the right upper and middle lobe accompanied but severe pectus excavatum. Right bilobectomy for pulmonary lesion and costosternal elevation for pectus excavatum was performed simultaneously with successful result. The postoperative course was uneventful and the patient was discharged on the twentieth postoperative day.
Child, Preschool ; Cough ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Female ; Fever ; Funnel Chest* ; Humans ; Infant, Newborn ; Lung ; Thorax ; Tomography, X-Ray Computed