Critical valvular aortic stenosis(AS) is a life threatening congenital heart anomaly in neonates or infants. The main cause of death is rapidly progressing left ventricular failure. The treatment goal of critical AS is to save left ventricular function early. Before the 1980s, the preferred treatment was surgical valvotomy, however, that operative method had a high mortality rate and risk of re- procedure. These surgical problems encouraged balloon aortic valvuloplasty technique for initial life saving. There were some vascular approaches for balloon aortic valvuloplasty(e.g. femoral artery and vein, umbilical artery and vein, carotid artery). Each approach has some advantages and disadvantages. Balloon aortic valvuloplasty through the right carotid artery makes access to the aortic valve easy, has less vascular complication, and short procedure time and effect of saving femoral artery for reballooning. We had three cases of transcarotid balloon aortic valvuloplasty in infants with critical AS. In our long-term follow up, we had good results, except carotid artery thrombosis in one case. We report the first three Korean cases of balloon aortic valvuloplasty though carotid artery cutdown procedure for critical AS with a brief review of literatures. (J Korean Pediatr Soc 2000;43:820-827)
Aortic Valve ; Aortic Valve Stenosis* ; Arteries ; Carotid Arteries ; Carotid Artery Thrombosis ; Cause of Death ; Femoral Artery ; Follow-Up Studies ; Heart ; Humans ; Infant* ; Infant, Newborn ; Mortality ; Umbilical Veins ; Veins ; Ventricular Function, Left

The obstruction of nasolacrimal conduit system which produces epiphora can be caused by congenital anomalies, chronic dacryocystitis, after trauma and facial paralysis. Dacryocystorhinostomy is a popular procedure for adult nasolacrimal duct obstruction. But various methods are used for flap formation and plugging. We performed 23 cases of the dacryocystorhinostomy with two mucosal flap of "U" shape from August 1993 to August 1996. Anterior flap was formed of nasal mucosa, and posterior flap was formed of lacrimal sac. The posterior flap was retracted through the nasal cavity by 6-0 black silk instead of suturing. Vaseline gauze was used as a plugging agent. Epiphora disappeared in 21 (91.3%) of 23 cases.
Adult ; Dacryocystitis ; Dacryocystorhinostomy* ; Facial Paralysis ; Humans ; Lacrimal Apparatus Diseases ; Nasal Cavity ; Nasal Mucosa ; Nasolacrimal Duct ; Petrolatum ; Silk

No abstract available.
Prognathism*

Lung cancer, breast cancer and lymphoma are the common oncologic causes of malignant pleural effusion, comprising more than the half of the causes. However, an endocrinologic carcinoma associated malignant effusion is very rare. Recently, we encountered a case of papillary thyroid carcinoma causing malignant effusion. An 83-year-old female patient presented with dyspnea due to massive pleural effusion in her left side. The pleural biopsy, pleural fluid cytology and breast needle aspiration biopsy results were consistent with a metastatic papillary thyroid carcinoma. Thyroid ultrasonography showed two thyroid masses, but the patient refused a thyroid biopsy. This case highlights the need for considering the possibility of papillary thyroid carcinoma when the cause of malignant pleural effusion cannot be found because one of the rare clinical manifestations of a papillary thyroid carcinoma can be dyspnea due to malignant effusion.
Aged, 80 and over ; Biopsy ; Biopsy, Needle ; Breast ; Breast Neoplasms ; Dyspnea ; Female ; Humans ; Lung Neoplasms ; Lymphoma ; Needles ; Neoplasm Metastasis* ; Pleural Effusion ; Pleural Effusion, Malignant ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonography

Lung cancer, breast cancer and lymphoma are the common oncologic causes of malignant pleural effusion, comprising more than the half of the causes. However, an endocrinologic carcinoma associated malignant effusion is very rare. Recently, we encountered a case of papillary thyroid carcinoma causing malignant effusion. An 83-year-old female patient presented with dyspnea due to massive pleural effusion in her left side. The pleural biopsy, pleural fluid cytology and breast needle aspiration biopsy results were consistent with a metastatic papillary thyroid carcinoma. Thyroid ultrasonography showed two thyroid masses, but the patient refused a thyroid biopsy. This case highlights the need for considering the possibility of papillary thyroid carcinoma when the cause of malignant pleural effusion cannot be found because one of the rare clinical manifestations of a papillary thyroid carcinoma can be dyspnea due to malignant effusion.
Aged, 80 and over ; Biopsy ; Biopsy, Needle ; Breast ; Breast Neoplasms ; Dyspnea ; Female ; Humans ; Lung Neoplasms ; Lymphoma ; Needles ; Neoplasm Metastasis* ; Pleural Effusion ; Pleural Effusion, Malignant ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonography