BACKGROUND: Microsatellites are short-tandem repeated uncleotide sequences present throughout the human genome. Alterations of microsatellites have been termed microsatellite instability(MI). It has been generally known that microsatellite instability detected in hereditary non-polyposis colorectal cancer (HNPCC) reflects genetic instability that is caused by impairments of DNA mismatch repair system regarding as a novel tumorigenic mechanism. A number of studies reported that MI occurred at varying frequencies in non-small cell lung carcinoma (NSCLC). However It has been unproven whether MI could be a useful market of genetic instability and have a clinical significance in NSCLC. MATERIAL AND METHOD: We have examined whether MI can be observed in thirty NCSLC using polymerase chain reaction whether such alterations are associated with other molecular changes such as p53, K-ras and c-myc oncoproteins expression detected by immunohistochemical stain,. RESULT: MI(+) was observed in 16.6%(5/30) and MI(-) was 83.3% (25/30) Average age was 50+/-7.5 year-old in MI(+) group and 57+/-6.6 year-old in MI(-) group. Two year survival rate in MI(=) group (20% 1/5) was worse than MI(-) group (64% 16/25) with a statistic difference. (P=0.04) The positive rate of K-ras oncoprotein expression and simultaneous expression of 2 or 3 oncoproteins expression were higher in MI(+) group than MI(-) group with a statistic difference(P=0.05, P=0.01) CONCLUSIONS: From, these results the authors can conclude that MI is found in some NSCLC and it may be a novel tumorigenic mechanism in some NSCLC. We also conclude that MI could be used as another poor prognostic factor in NSCLS.
Colorectal Neoplasms ; DNA Mismatch Repair ; Genome, Human ; Humans ; Lung Neoplasms ; Lung* ; Microsatellite Instability* ; Microsatellite Repeats* ; Oncogene Proteins ; Polymerase Chain Reaction ; Survival Rate

Thoracoscopic esophagectomy can be performed in esophageal diseases to reduce the postoperative complications. Recently, We encountered a case of esophageal cancer and successfully treated it by thoracoscopic esophagectomy with gastric pull-up. A 59-year-old male was presented with swallowing difficulty and an esophagogram, esophagoscopy, and chest CT showed an ulcerating tumor on the lower esophagus. The operation was performed in three stages: mobilization of the esophagus by thoracoscopic surgery, construction of a gastric tube through a laparotomy, and cervical anastomosis between the esophagus and the gastric pull-through. Hoarseness developed postoperatively, and the postoperative esophagogram showed leakage at the esophagogastric anastomotic site. The anastomotic leakage was healed following surgical drainage and the patient was discharged in good health. Hoarseness subsided spontaneously two months after surgery.
Anastomotic Leak ; Deglutition ; Drainage ; Esophageal Diseases ; Esophageal Neoplasms* ; Esophagectomy* ; Esophagoscopy ; Esophagus ; Hoarseness ; Humans ; Laparotomy ; Male ; Middle Aged ; Postoperative Complications ; Thoracoscopy ; Tomography, X-Ray Computed ; Ulcer

It is now generalized to perform cardiac surgery in the patients with end-stage renal disease. The growing number of patients with chronic renal failure wake us up to the need to prepare for proper management. There are not only the prevalence of coronary artery disease, but also a great amount of valve dysfunction exist in this group. Peritoneal dialysis may be one of the obstacles for cardiopulmonary bypass but it is not a great hindrance in cardiac surgery with careful preparation and well organized perioperative care. The author has performed mitral valve replacement in a 33-year-old anuric female patient with chronic renal failure and severe mitral insufficiency. Preoperatively, the patient was kept in adequate fluid and electrolyte balance using peritoneal dialysis. Peritoneal dialysis continued and regulated according to the laboratory data in this patient during and after the surgery. She recovered well showing an uneventful course and was discharged on postoperative 1 th day.
Adult ; Cardiopulmonary Bypass ; Coronary Artery Disease ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic* ; Mitral Valve ; Mitral Valve Insufficiency ; Perioperative Care ; Peritoneal Dialysis ; Prevalence ; Thoracic Surgery ; Water-Electrolyte Balance

No abstract available.
Pancytopenia*

It would be possible to manage the intestinal anastomotic failure with intraluminal stenting, but its reports are very rare. We experienced a effective and dramatic improvement of esophago-jejunal anastomotic leak in a esophageal and gastric double cancer patient with intraluminal stenting. The intraluminal stenting was tried at the 28th postoperative day and the anastomotic leak and inflammatory signs were disappeared about 3 weeks later. Postoperative 11th months now, the stent was moved about 1 cm downward but not changed further, and he enjoys regular diet without any problems. And we think the stenting would be helful with some limitations in the intestinal anastomotic leak patient.
Anastomotic Leak ; Diet ; Esophageal Neoplasms ; Fistula ; Humans ; Stents*

From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5+/-12.2 years. Seventeen (63.0%) patients had the mitral valve replacement, 8 (29.6%) the aortic valve, 1 (3.7%) the aortic composite graft, and 1 (3.7%) the tricuspid valve. Mean follow-up period was 49.5+/-30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9+/-34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis (1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2+/-43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak (4/15, 26.7%), and valve thrombosis (3/15, 20.0%). Posto-perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.
Aortic Valve ; Bioprosthesis ; Cardiac Output, Low ; Endocarditis ; Female ; Follow-Up Studies ; Heart Valve Prosthesis* ; Heart Valves* ; Humans ; Male ; Mitral Valve ; Prostheses and Implants ; Reoperation* ; Thrombosis ; Transplants ; Tricuspid Valve

Facial hyperhidrosis has a symptom of excessive sweating on the face with or without underlying disease. It can be surgically treated by video-assisted thoracic surgery (VATS). We encountered three cases of facial hyperhidrosis which we treated by VATS, which was performed by resection of the lower third of stellate ganglion and T2-T3 sympathetic ganglia with chains. Postoperative symptom was improved in all cases. There were no postoperative complications such as Horner's syndrome or postsympathectomy neuralgia.
Ganglia, Sympathetic ; Horner Syndrome ; Hyperhidrosis* ; Neuralgia ; Postoperative Complications ; Stellate Ganglion ; Sweat ; Sweating ; Sympathectomy* ; Sympathetic Nervous System ; Thoracic Surgery, Video-Assisted

Endoscopic sympathicotomy is the choice of the treatment for hyperhidrosis. There are some recognized risks such as Honer's syndrome and Hemopneumothorax; however, Chylothorax has very rarely been reported after thoracic sympathicotomy. We recently encountered a case of chylothorax. Early diagnosis and prompt treatment is noteworthy.
Chylothorax* ; Early Diagnosis ; Hemopneumothorax ; Hyperhidrosis

Percutaneous transthoracic fine needle biopsy has been widely used In the diagnosis of pulmonary lesions especially lung cancer. Onc of the rarest complication's is that malignant cells are implanted within the needle tract and developed a chest wall mass subsequently. Wc expcrlenccd a case of chest wall implantatio of lung cancer after percutaneous transthoracic floe needle biopsy. A 65-ycar old man had undergone bilobectomy (right upper lobe and right middle lobe)for squamous cell carcinoma (T2N0M0) of the lung. 60 days after percutaneous biopsy (48 days after operation), a tiny nodule (1 mm sized) was notcd at the right anterior chcst wall where the diagnostic fine needle biopsy had been performed before operation. This tiny mass was rapidly growing to 1.5 cm sized mass for 20 days. We carried out wide excision of chest wall mass and skin grafting, and confirmed squamous cell carcinoma histopathologically as same as the lung cancer.
Biopsy ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Carcinoma, Squamous Cell ; Diagnosis ; Lung Neoplasms* ; Lung* ; Needles ; Neoplasm Metastasis ; Skin Transplantation ; Thoracic Wall* ; Thorax*

BACKGROUND: Thoracic sympathectomy for hyperhidrosis has been recognized as an effective treatment using thoracoscopic devices and operative techniques, but the satisfaction has decreased due to a compensatory hyperhidrosis. Therefore, the postoperative results and compensatory hyperhidrosis were analyzed. We also measured the temperature differences in the hand and foot during the preoperative and postoperative periods and measured the blood flow of upper and lower extremities. MATERIAL AND METHOD: From December 1995 to July 1998, total of 47 patients with hyperhidrosis underwent sympathectomy via VATS at the Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital. The patients were evaluated for preoperative and postoperative temperature changes on the finger and toe, and preoperative and postoperative blood flows were measured by the Doppler examination on the digital artery, radial artery and dorsalis pedis artery. RESULT: There were no operative deaths but some complications existed: 7 pneumothorax, 3 recurrence and 1 Honor syndrome. Ninety-five percent of the patients also had compensatory sweating especially in the trunk. There were 5 patients who regretted recurring the operation because of the compensatory sweating. Sweating decreased in 46% of the sole hyperhidrosis patients. The temperature difference between preoperation and postoperation was 1degree C on the right hand side and 1.9degree C on the left hand side(p<0.05). There was no significant temperature difference on the sole. Blood flow increased significantly in the palm, but no difference in the sole. CONCLUSION: In conclusion, thoracic sympathectomy for hyperhidrosis is a safe and effective treatment but satisfaction has been decreased by the compensatory sweating; therefore, it is important to thoroughly explain the compensatory sweating prior to surgery. Improvement of the plantar hyperhidrosis is not due to a physiological change, but to a psychological stability.
Arteries ; Fingers ; Foot ; Hand ; Humans ; Hyperhidrosis* ; Lower Extremity* ; Pneumothorax ; Postoperative Period ; Radial Artery ; Recurrence ; Regional Blood Flow ; Sweat* ; Sweating* ; Sympathectomy ; Thoracic Surgery, Video-Assisted ; Toes