No abstract available.

During the period from january, 1972, to march, 1979, Twenty-four patients underwent mitral valve replacement at the seoul national University Hospital. Their ages ranged from 8 years to 20 years, with 11 patients being 16 years of age or younger at the time of operation. There were 12 males and 12 females and their weight ranged from 25 to 53 Kilograms. Seventeen patients had advanced stages of heart disease as evidenced by the functional classification: 14 cases were in functional class III and 3 cases in functional class IV (New York heart Association). A history suggestive of rheumatic fever was elicited in 75 per cent of our patients. Radiographic evaluation demonstrated marked cardiomegaly in the majority of the patients. The cardiothoracic ratio was over 70 per cent in 5 patients and between 60 and 70 per cent in 17 patients. Cardiac catheterization was carried out in all patients before operation. There were 3 patients with evidence of severe pulmonary hypertension. In 2 patients the pulmonary artery pressures were normal. On physical and hemodynamic examinations, 3 patients had associated with aortic regurgitation, 2 patients had tricuspid regurgitation, 1 patient had tricuspid and aortic regurgitations and 3 patients had atrial septal defect or ventricular septal defect or transposition of great arteries. The pathologic findings of the mitral valve indicated rheumatic valvulitis in 16 patients, while in the remaining 7 the etiology was undetermined. In only one patient the cause was congenital cardiac anomaly. Seventeen patients had predominant mitral regurgitation and 7 patients predominant mitral stenosis. Twenty-nine cardiac prosthetic and bioprosthetic valves were replaced in 24 patients in the past 8 years. This series included 24 mitral, 4 aortic and 1 tricuspid valve replacement. Including in this group were patients who had concomitant aortic valve replacement(3 patients), tricuspid valve replacement(1 patient), tricuspide annuloplasty and closure of ventricular septal defect(1 patient), and closure of atrial septal defect and ventricular septal defec(3 patients). There were five deaths in the postoperative period, resulting in an operative mortality rate of 20.8 per cent. high postoperative mortality was seen in the patients with associated aortic valvular disease and congenital cardiac anomaly.
Adolescent* ; Aortic Valve ; Aortic Valve Insufficiency ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Child* ; Classification ; Female ; Heart ; Heart Diseases ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Male ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Mortality ; Postoperative Period ; Pulmonary Artery ; Rheumatic Fever ; Seoul ; Transposition of Great Vessels ; Tricuspid Valve ; Tricuspid Valve Insufficiency

During the period from january, 1972, to march, 1979, Twenty-four patients underwent mitral valve replacement at the seoul national University Hospital. Their ages ranged from 8 years to 20 years, with 11 patients being 16 years of age or younger at the time of operation. There were 12 males and 12 females and their weight ranged from 25 to 53 Kilograms. Seventeen patients had advanced stages of heart disease as evidenced by the functional classification: 14 cases were in functional class III and 3 cases in functional class IV (New York heart Association). A history suggestive of rheumatic fever was elicited in 75 per cent of our patients. Radiographic evaluation demonstrated marked cardiomegaly in the majority of the patients. The cardiothoracic ratio was over 70 per cent in 5 patients and between 60 and 70 per cent in 17 patients. Cardiac catheterization was carried out in all patients before operation. There were 3 patients with evidence of severe pulmonary hypertension. In 2 patients the pulmonary artery pressures were normal. On physical and hemodynamic examinations, 3 patients had associated with aortic regurgitation, 2 patients had tricuspid regurgitation, 1 patient had tricuspid and aortic regurgitations and 3 patients had atrial septal defect or ventricular septal defect or transposition of great arteries. The pathologic findings of the mitral valve indicated rheumatic valvulitis in 16 patients, while in the remaining 7 the etiology was undetermined. In only one patient the cause was congenital cardiac anomaly. Seventeen patients had predominant mitral regurgitation and 7 patients predominant mitral stenosis. Twenty-nine cardiac prosthetic and bioprosthetic valves were replaced in 24 patients in the past 8 years. This series included 24 mitral, 4 aortic and 1 tricuspid valve replacement. Including in this group were patients who had concomitant aortic valve replacement(3 patients), tricuspid valve replacement(1 patient), tricuspide annuloplasty and closure of ventricular septal defect(1 patient), and closure of atrial septal defect and ventricular septal defec(3 patients). There were five deaths in the postoperative period, resulting in an operative mortality rate of 20.8 per cent. high postoperative mortality was seen in the patients with associated aortic valvular disease and congenital cardiac anomaly.
Adolescent* ; Aortic Valve ; Aortic Valve Insufficiency ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Child* ; Classification ; Female ; Heart ; Heart Diseases ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Male ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Mortality ; Postoperative Period ; Pulmonary Artery ; Rheumatic Fever ; Seoul ; Transposition of Great Vessels ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Bronchial artery embolization is well-accepted and widely used for management of massive and recurrent hemoptysis. This may either provide a definite therapeutic measure or a stabilizing effect on the patents in preparation for surgery. Retrospectively we reviewed 129 cases(106 patients) of bronchial artery embolization with Gelfoam pudding & Ivalon for control of hemoptysis from July 1985 to january 1991. The causes of hemoptysis were pulmonary tuberculosis(80.2%). Bronchiectasis(11.3%), asperigilloma(2.8%), and others(5.7%). The cases of pulmonary tuberculosis included tuberculous bronchiectasis (40.0%), active(34.1%), undetermined(14.1%) and inactive(11.8%). @ES The results were as follows: @EN Immediate control of hemoptysis was achieved in 104 of 122 cases(85.2%). Immediate control of massive hemoptysis was achieved in 94 of 107 cases(87.6%) and of chronic intermittent hemoptysis in 10 of 15 cases(76.0%). Hemoptysis recurred in 39 of 90 follow up cases(43.3%) on follow-up studies performed ranging in period from 2 to 49 month after the initial studies. Thirty three of 81 cases of massive hemoptysis recurred(40.7%) and six of 9 cases of chronic intermittent hemoptysis recurred(67.0%). One years rebleeding rate of massive hemoptysis was 34.6%. The rebleeding cases of massive hemoptysis were controlled by conservative treatment in 25 of 33 cases(75.8%). In conclusion. Bronchial artery embolization for hemoptysis control is effective in massive hemoptysis, but nearly ineffective in chronic intermittent hemoptysis, The goal of bronchial artery embolization is lifesaving procedure without permanent effect. Especially hemoptysis related to pulmonary tuberculosis.
Bronchial Arteries* ; Bronchiectasis ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Hemoptysis ; Retrospective Studies ; Tuberculosis, Pulmonary

No abstract available.

Primary cancer af the duodenum is rare. An extensive experience with fiberoptic eaophag-ogastro-duodenoscopy in our institution has indicated that duodenal cancer may be more frequent thsn suspeeted and readily diagnesed by this modality, With this in mied, clinical, pathological, diagnostic and therapeetie aspects of the 26 patients with primary duodenal cancer which had been endoscopically diugnosed were reviewed. The results obtained were as follows: 1) Ages ranged from 16 to 75, with the mean of 55.2 years. Seventeen patients were men and nine patients women being l. 9:1 of male-female ratio. 2) Hndoscoyic findings were 46. 1 percent ulcerative anld 34. 8 per cent ulcerative-infiltrative, 3) The diatribution within the duodenum was 50 per cent suprapapillary, 42. 4 per cent peri- papillary aecl 7. 6 per cent infrapapillary. 4) The twenty-three patients had adenocarcinoma, two patients leiomyosarcoma and 1 patient lymphoma. 5) Twenty patients were confirmed by duodenoseopic biipsies and six patients by operations. 6) The mast common presenting mmyliiints were abdominal pain, chronic blood lais leading anemia, jaundice, anorexia, indigestion, weight lass and palpable abdominal mass. 7) Of the 26 patients, eight patients underwent attempted curative resection, six patients underwent palliative bypasa procedures or exploratory laparotomy.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Anorexia ; Diagnosis* ; Duodenal Neoplasms ; Duodenum ; Dyspepsia ; Female ; Humans ; Jaundice ; Laparotomy ; Leiomyosarcoma ; Lymphoma ; Male ; Ulcer

Postcholecystectomy syndrome is the persistence or recurrence of symytom complex following cholecystectomy, The majority of the patients have mild symptoms. However, the cause of recurrent symptoms is often obscure and as a consequence, a plan of management is difficult to formulate. Recently ERCP has proved to be increasingly helpful in the investigation of postcholecystectomy patients. The purpose of this study was to test the effectiveness of the ERCP in the evaluation of patients with postcbiolecystectomy syndrorae. The results are as follows 1) 102 postcholecystectomy patients were studied by endoscopic retrograde cholangiopancreatography and successful cannulation with demonstration of at least one duct was achieved in 49 of 50 jaundiced patients and in 49 of 52 non-jaundiced patients. The overall success rate was 96. 1%. 2) The results of ERCP were normal in 26 patients(26.5%) and abnormal in 72 patients (73.5%), Only 3 of 50 jaundiced patients were normal, but 23 of 52 non-jaundiced patients showed no abnormal findings. 3) The most common abnormality was biliary stone in common bile duct and intrahepatic duct which were present in 51 patients(50%). Cholangitis without stone was next common finding which was in 13 patients(13%). Of the remaining patients have air biligram, 2 CBD stricture, 1 CBD aseariasis & 1 chronic pancreatitis. 4) Time lapse between onset of symptoms and cholecystectomy was variable. 31 patients were studied less than 2 years after cholecystectomy. 18 of these patients had jaundice and 13 had no jaundice. Within 2 years afte chklecystectomy, the biliary stone was most common finding which were present in 14 out of 31 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Jaundice ; Pancreatitis, Chronic ; Postcholecystectomy Syndrome ; Recurrence

Blue Rubber Bleb Nevus syndrome, or Bean's syndrome is a very rare disease characterized by an association of 1) hemangioma cutis in which the nevi feel like rubber blebs; 2) hemangiomas of the digestive organs; 3) iron-deficiency anemia due to hemorrhage from the digestive tract. Sometimes, the bleeding is so severe and massive that the patient needs blood transfusions and/or emergency operations. We present a 29-year-old man with Blue Rubber Bleb Nevus syndrome. This patient was admitted to out hospital due to recently aggrevated dizziness and intermittent rectal bleeding. Multiple bluish tumors were noted on the palm, sole and glans penis. Laboratory examination revealed severe iron-deficiency anemia. Barium studies revealed multiple polypoid masses in the stomach, small bowel and colorectum. On esophagogastroduodenoscopy and colonoscopy, three or four dozens of hemangiomas with variable size and shape were noted in the stomach, duodenum at or around the ampulla of Vater and colorectum. This patient was of particular interest because rectal bleeding occurred from rectal lesion which protruded out of anus and caused bleeding during defecation, and which showed as a 2.0 cm Yamada type III polypoid lesion. Endoscopic ultrasonography confirmed us that this lesion was confined to the mucosa and submucosa without extension into muscle layer. Endoscopic polypectomy of this lesion was performed because which considered as the main focus of current rectal bleeding. He was discharged without any complication and 4 months later, he was well without rectal bleeding and his hemoglobin level increased upto 13.5 g/dl. To our knowledge, this is the first case of Blue Rubber Bleb Nevus syndrome in Korea.
Adult ; Ampulla of Vater ; Anal Canal ; Anemia, Iron-Deficiency ; Barium ; Blister* ; Blood Transfusion ; Colonoscopy ; Defecation ; Dizziness ; Duodenum ; Emergencies ; Endoscopy, Digestive System ; Endosonography ; Gastrointestinal Tract ; Hemangioma ; Hemorrhage ; Humans ; Korea ; Male ; Mucous Membrane ; Nevus* ; Penis ; Rare Diseases ; Rubber* ; Stomach

PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

Intravascular injection of hydrogen peroxide produces oxygen microbubbles suitable for echocardiographic contrast enhancement. To evaluate the effect of a method of myocardial contrast 2-D-echocardiographic delineation of myocardium during acute coronary occlusion, injection of a fresh mixture of 2ml of 0.2% H2O2 and 1ml of heparinized dog blood into aortic root were made in 12 poenchest dogs 10 minutes after occlusion of left anterior descending coronary artery distal to the first diagonal branch and left ventricular short axis 2-D echocardiographic images at the midpapillary muscle level were obtained. On injection of H2O2 blood mixture normally perfused myocardium was enhanced in echodensity but the area of malperfusion did not change in echodensity. The borderlines between the area of normal perfusion and malperfusion was well delineated. The malperfused area measured at mid papillary muscle level by planimetry area method was 29.7+/-6.0% and 32.6+/-6.7% by endocardial circumferential length method. There was a linear correlation between planimetric estimate of area of malperfusion by H2O2 contrast echocardiography and visual determination of regional wall motion abnormality by 2-D echocardiography(r=0.93, P<0.001). There was no change in heart rate before, during and after H2O2 injection. Infection of H2O2 blood mixture caused bradycardia(8.3%), second degree A-V block(16.6%) and ventricular fibrillation(8.3%). H2O2 clearance was achieved in 3-10 minutes. These findigs suggest that H2O2 enhanced myocardial contrast ehocargiography using 2ml of 0.2% H2O2 and 1ml of blood muxture is an accurate, reproducible, real-time in vivo method of quantifying the extent of myocardial perfusion defect during acute coronary occlusion in dog.
Animals ; Axis, Cervical Vertebra ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Echocardiography* ; Heart Rate ; Heparin ; Hydrogen Peroxide* ; Hydrogen* ; Microbubbles ; Myocardium ; Oxygen ; Papillary Muscles ; Perfusion*