배우자간의 C형 간염 항체 양성율

이창구,김종수,최은석,전무련,추성욱,허충,이진관 大韓消化器病學會 1997 大韓消化器病學會誌 Vol.29 No.2

배우자간의 C형 간염 항체 양성율

이창구(Chang Goo lee),김종수(Jong Su Kim),최은석(Eun Suk Choi),전무련(Mu Ryeun Jeun),추성욱(Sung Uk Chu),허충(Chung Hur),이진관(Jin Kwan Lee) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2

N/A Background/Aims: Parenteral exposure, such as transfusion, drug abuse, needle stick injury, tatooing, hemodialysis and transplantation, is well documented as the major route of transmission. But about half of hepatitis C virus(HCV) carriers have no previous history of parenteral infection. Therefore, other possible routes of the spread should be evaluated. The possibility of intrafomilial transmission of HCV was considered to be low as compared to that of hepatitis B virus(HBV), but recent publications from Japan and Europe elicit the interest in intrafamilial transrmission, especially in spousal transmission. The aim of this study is to investigate the possibility of spousal transmission of HCV. Methods: We analyzed clinical features, serum transaminase and anti-HCV in 56 spouses who got married to anti-HCV positive patients. The mean age in index cases was 44.7 years, 45.6 in male and 43.2 in female and that of spouses was 42.4 yenrs, 45.7 in male and 40.7 in female. The mean duration of marriage was 20,0 years, distributed from 1 to 50. Index cases included 8 asymptomatic carriers, 44 chronic hepatitis, 3 liver cirrhosis and 1 hepatoma. Four of those had previous history of blood transfusion. Results: Among 56 spouses, anti-HCV was detected in 9 cases representing 16.1%. Four of those were clinically asymptomatic carriers and remaining 5 had chronic hepatitis. The mean age in index cases of anti-HCV positive spouses was 56 years old and was older than that of anti-HCV negative spouses 42.6(P<0.01). The mean duration of marriage in index cases of anti-HCV positive spouses was 30,9 years and was longer than that of anti-HCV negative spouses 18.0(P<0.05). Conclusions: This study revealed higher prevalence of anti-HCV in spouses who got married to anti-HCV positive carriers compared to that of general population. As the duration of marriage was getting longer, the frequency of anti-HCV in spouses increased(P<0.01). These results suggest that the spouses of anti-HCV positive carriers could be a high risk group for HCV transmission. (Korean J Gastroenterol 1997; 29:207 - 213)

HeartMate 3 Implantation via Only Left Thoracotomy: A Case Report

Jang Mi Young,Lee Jun Ho,Chung Su Ryeun,Sung Kiick,Kim Wook Sung,Cho Yang Hyun 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.3

Median sternotomy is a standard surgical technique used for left ventricular assist device (LVAD) implantation. However, if sternotomy has a prohibitive surgical risk, LVAD implantation can be performed through only left thoracotomy. We managed a patient with endstage heart failure who had recently undergone coronary artery bypass grafting (CABG) elsewhere. The patient also had a deep sternal wound infection and bacteremia. Because of refractory cardiogenic shock, we performed extracorporeal membrane oxygenation (ECMO). After multiple mediastinal washouts and omental flap placement, ECMO was converted to extracorporeal LVAD (from the left ventricular apex to the descending aorta) through a left thoracotomy. The extracorporeal LVAD was maintained for 18 days and replaced by the HeartMate 3 LVAD. The patient was discharged in good condition 115 days after CABG.

Pericardial Window Operation in Oncology Patients: Analysis of Long-Term Survival and Prognostic Factors

Kim Sung Min,Lee Jun Ho,Chung Su Ryeun,Sung Kiick,Kim Wook Sung,Cho Yang Hyun 대한심장혈관흉부외과학회 2024 Journal of Chest Surgery (J Chest Surg) Vol.57 No.2

Background: Pericardial effusion (PE) is a serious condition in cancer patients, primarily arising from malignant dissemination. Pericardial window formation is a surgical intervention for refractory PE. However, the long-term outcomes and factors associated with postoperative survival remain unclear. Methods: We retrospectively analyzed data from 166 oncology patients who underwent pericardial window formation at Samsung Medical Center between 2011 and 2023. We analyzed survival and PE recurrence regarding surgical approach, cancer type, and cytopathological findings. To identify factors associated with survival, we utilized Cox proportional- hazards regression. Results: All patients had tumors documented in accordance with the American Joint Committee on Cancer staging manual, including lung (61.4%), breast (9.6%), gastrointestinal (9.0%), hematologic (3.6%), and other cancers (16.4%). Surgical approaches included mini-thoracotomy (67.5%) and thoracoscopy (32.5%). Postsurgical cytopathology confirmed malignancy in 94 cases (56.6%). Over a median follow-up duration of 50.0 months, 142 deaths and 16 PE recurrences occurred. The 1-year overall and PE recurrence-free survival rates were 31.4% and 28.6%, respectively. One-year survival rates were significantly higher for thoracoscopy recipients (43.7% vs. 25.6%, p=0.031) and patients with negative cytopathology results (45.1% vs. 20.6%, p<0.001). No significant survival difference was observed between lung cancer and other types (p=0.129). Multivariate analysis identified New York Heart Association class, cancer stage, and cytopathology as independent prognostic factors. Conclusion: This series is the largest to date concerning window formation among cancer patients with PE. Patients’ long-term survival after surgery was generally unfavorable. However, cases with negative cytopathology or earlier tumor stage demonstrated comparatively high survival rates.

Aortic Valve Replacement and Concomitant Multi-Vessel Coronary Artery Bypass: The Impact of Using the Bilateral Internal Thoracic Arteries on Early and Late Clinical Outcomes

Heo MuHyung,Kim Myoung Young,Lee Jun Ho,Chung Su Ryeun,Sung Kiick,Kim Wook Sung,Cho Yang Hyun 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.3

Background: The survival benefit of coronary artery bypass grafting (CABG) using the bilateral internal thoracic arteries (BITA) is well known; however, the role of BITA in concomitant aortic valve replacement (AVR) and CABG has not been studied. Methods: We retrospectively reviewed patients who underwent concomitant AVR and CABG. Cases not using an internal thoracic artery and less than 2 bypass grafts were excluded. We enrolled 114 patients in this study. The mean follow-up duration was 61.5±43.5 months. Results: Forty patients (35.1%) underwent CABG with a single internal thoracic artery (SITA) and 74 patients (64.9%) underwent CABG with BITA. The preoperative clinical characteristics were not significantly different between the 2 groups, with the exception of a higher prevalence of atrial fibrillation in the SITA group. Postoperative mortality and morbidity were not significantly higher in the BITA group than in the SITA group. In the univariable analysis, the survival of the BITA group was similar to that of the SITA group (p=0.157). Multivariable analysis showed that only mean age was a predictor of death (p=0.042), but using BITA was not an independent predictor (p=0.094). In low-risk patients whose preoperative ejection fraction was >45%, the survival of the BITA group was significantly better than that of the SITA group (p=0.043). Conclusion: BITA use in concomitant AVR and CABG showed no difference in mortality compared to using SITA. Although its impact on long-term survival was inconclusive, BITA use can be considered for low-risk patients.

Impact of Interatrial Septal Reconstruction on Atrial Tachyarrhythmia after Surgical Resection of Myxoma

Jang Mi Young,Lee Jun Ho,Heo MuHyung,Lim Suk Kyung,Chung Su Ryeun,Sung Kiick,Kim Wook Sung,Cho Yang Hyun 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.3

Background: Complete surgical excision is the only curative treatment for primary cardiac tumors. For wide excision, interatrial septal reconstruction (ISR) is commonly performed. We hypothesized that ISR may increase the risk of postoperative atrial tachyarrhythmia (AT) after surgical resection of cardiac myxoma. Methods: After excluding patients with a history of cardiac surgery and concomitant procedures unrelated to tumor resection and those with AT or permanent pacemakers, we finally enrolled 272 adult patients who underwent benign cardiac tumor surgery from 1995 to 2021 at our institution. They were divided into the ISR (n=184) and non-ISR (n=88) groups. The primary outcome was postoperative new-onset AT. Results: The study cohort predominantly consisted of women (66.2%), with a mean age of 57.2±13.6 years. The incidence of postoperative new-onset AT was 15.4%. No 30- day mortality or recurrence was observed. The cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the ISR group than in the non-ISR group (p<0.001). The median duration of hospital stay of all patients was 6.0 days (interquartile range, 5.0–7.0 days), and no significant difference was observed between the 2 groups (p=0.329). ISR was not an independent predictor of new-onset AT (p=0.248). Male sex and hypertension were found to be independent predictors of new-onset AT. Conclusion: ISR was not a significant predictor of postoperative new-onset AT. ISR might be a feasible and safe procedure for surgical resection of cardiac myxoma and should be considered if needed.