Clinical Result of the Patent Ductus Arteriosus in the Premature Infants / 대한흉부외과학회지

BACKGROUND: This study is to suggest the optimal method as a treatment for the patent ductus arteriosus in the premature infants. MATERIAL AND METHOD: Between April 1994 and April 1997, 45 premature infants with evidence of a hemodynamically significant patent ductus arteriosus associated with cardiopulmonary compromise underwent indomethacin therapy, surgical treatment, or both. Thirty-nine infants received indomethacin and twelve infants among them were surgically ligated because of indomethacin failure(5) or complications(7). Six infants, who weighed less than 1,500 gm at birth, were referred for primary surgical ligation because of contraindication to indomethacin therapy. RESULT: The failure rate of indomethacin therapy was 43%(17/39) and the complications(13/39, 33%) to the indomethacin were associated with a high morbidity and mortality. Among the infants who underwent ligation, there were no failures and complications related to the operation. This data suggests that in the premature neonate with a hemodynamically significant PDA, (1) indomethacin therapy is associated with a high failure rate and significant complications, (2) surgical duct closure is associated with minimal morbidity. CONCLUSION: Although the results of this study cannot suggest the optimal management for PDA in premature infants, primary surgical ligation may be considered. However, long-term studies will be needed to confirm this later.

Diffuse Leiomyomatosis of The Esophagus: A Case Report / 대한흉부외과학회지

Though leiomyomas are the commonest benign tumors in the esohpagus, the vast majority of the leiomyomas of alimentary tract occurs outside the esophagus. Leiomyoma is mostly solitary, and multiple lesions are rare. Diffuse esophageal leiomyomatosis is a very rare disease, which is the condition having diffuse thickening of esophageal musculature and with or without discrete lesion. We are reporting a typical case of diffuse leiomyomatosis of the esophagus in a 37-year-old woman successfully resected.

Hibernoma of Lower Chest Wall, Left: One Case Report / 대한흉부외과학회지

Hibernoma is a rare, benign soft tissue tumor that is derived from the remnants of fetal brown tissue. The term hibernoma was proposed in 1914 by Cery because of its morphologic similarity to the cel s of the so-called hibernating gland of animals. The most common site of hibernomas is the subcutaneous tissue of the back, especially the interscapular area. These tumors are considered benign and malignant transformation has not been reported. We experienced a case of hibernoma, 60-year-old woman had suffered from the palpable mass without pain or tenderness on posterolateral lower chest wall, left. The tumor was extirpated under the impression of angiolipoma, but was confirmed hibernoma. She was discharged without complication.

Totally Implantable Venous Access Devices In Pediatric Surgery Patients

Long-term venous access devices have become an important part of the stantard care for children with malignant disease requiring chemotherapy. Totally implantable venous access system(TIVAS) gained widespread use and acceptance in the management of children with cancer in whom frequent and prolonged venous access is required. We analysed our experiences of insertion and use of totally implantable venous access device in 70 pediatric patients(79 devices), between April 1991 and April 1996. Median age of patients was 6 years and 10 months old. Median duration of utilization was 320 days(range 7-1449 days). Access vein was right external jugular vein(46.8%), left external jugular vein(21.5%), right internal jugular vein(11.4%), left internal jugular vein(3.8%), right subclavian vein(1.3%), left subclavian vein (7.6%), right cephalic vein(2.5%), left cephalic vein(5.1%). Complications related to surgical factors included: wound dehiscence(3 cases), hematoma(1 case), malposition of catheter(1 case). Complications not related to surgical factors included: occlusion of catheter(12 cases), wound infection(7 cases), sepsis(6 cases), leakage(3 cases), hematoma(3 cases), thrombosis of vein (1case). Many complications resolved spontaneously or with medical threatment and 14 cases(17.7%) required removal of system. We conclude that with long-term usage of totally implantable venous access system making it a safe and viable alternative for patients requiring long-term intravenous therapy.