• Title/Summary/Keyword: 심기

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Corrective Surgery of Congenital Cardiac Anomalies in the Noonan syndrome - Report of two cases - (Noonan 증후군에 동반된 심기형의 수술적 교정 - 2례 보고 -)

  • 이선희;이주현;심성보;박재길;곽문섭;김세화;오용석;윤호중;정욱성
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.552-555
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    • 2001
  • Noonan syndrome is characterized by a Turner-like phenotype and a normal karyotype associated with congenital abnormalities, such as short stature, variable mental retardation, hypertelorism, webbed neck, low posterior hair line, skeletal malformation and congenital cardiovascular defect. Two third of Noonan syndrome have cardiac anormalies, half with pulmonary stenosis. We have experienced two cases of pulmonary stenosis associated with other cardiac anomalies in Noonan syndrome. The first 31-year-old male patient had characteristic appearance of Noonan syndrome with severe infundibular pulmonic stenosis and patent foramen ovate. The second 28-year-old male patient had valvular and subvalvular Pulmonary stenosis with typical Noonan\`s face and stature. Pulmonary valvotomy and hypertrophied muscle bundles in the right ventricular cavity were resected in both cases. Patent foramen ovate was closed directly in the first case. Postoperative follow-up examinations revealed no symptoms and successful outcome.

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Imaging Diagnosis: Heartbase Tumor in a Dog (개의 심기저부 종양의 영상진단학적 특징)

  • Chang, Jin-Hwa;Jung, Joo-Hyun;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.48-51
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    • 2008
  • A ten-year-old Yorkshire Terrier developed serious abdominal distension and respiratory distress. Radiography and ultrasonography revealed a hyperechoic mass around the aorta that was contiguous with the right atrium and main pulmonary artery. It was resulted in failure of the right side of the heart including tricuspid regurgitation, hepatomegaly with dilation of the hepatic vein and severe ascites due to a large, expansile mass. Computed tomography(CT) identified a large mass originating at the cardiac hilar region and spanning from the cranial vena cava to the caudal vena cava. The tumor had invaded the cranial vena cava, caudal vena cava, heart and pleural wall. A tentative diagnosis of chemodectoma was assigned to the tumor through a fine needle aspiration. This report focuses on the typical features of imaging diagnosis of heartbase tumors by radiography, ultrasonography and CT.

Surgical Correction of Ebstein's Anomaly -11 cases- (Ebstein 기형의 외과적 치료 - 11례 -)

  • 이선희;김시훈;윤정섭;김치경;조건현;왕영필;곽문섭;김우찬
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1202-1206
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    • 1996
  • Ebstein's anomaly is an unusual and a rare congenital cardiac malformation but characteristic abnormality of the development of the tricuspid valve, right atrium and ventricle. The characteristic findings are a displaced tricuspid valve with a septal leaflet spiralling into the right ventricle. The surgical correction is variable and are left unsolved problem in surgical treatment of anomaly. Between January 1988 & December 1995, we experienced 11 cases of Ebstein's anomaly and associated cardiac anomalies are ASD, PFO, ASD with VSD. The typically displaced tricuspid valve leaflet was found in all cases. In the NYHA functional classification, three were in class II, seven were in class III, and one was in class IV. Nine patients were operated by tricuspid annuloplasty & plication with Danielson's method and two patients were done by tricuspid valve replacement with plication, and in all cases associated anomaly was corrected. Postoperatively, five patients suffered from complication - low cardiac output syndrome, arrhythmia and wound infection. There was no operative mortality and the postoperative courses were relatively good conditions with more improvement of symptoms.

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One-stage Repair of Aortic Arch Anomalies and Intracardiac Defects through Median Sternotomy (정중 흉골절개를 통한 대동맥궁 기형과 심기형의 일차교정술)

  • Chang Yun Hee;Lee Sang Kwon;Lee Hyung Doo;Kim Siho;Yie Kilsoo;Woo Jong Soo;Lee Young Seok;Sung Si Chan
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.291-300
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    • 2005
  • One-stage repair of aortic arch anomalies and intracardiac defects through median sternotomy has been recently adopted by many institutions since it is known to be safer than the staged repair. The early and midterm results of the one-stage repair of aortic arch anomalies and intracardiac defects were retrospectively evaluated. Material and Method: 45 patients who underwent one-stage repair of aortic arch anomalies and intracardiac defects performed by one surgeon from January 1996 to July 2003 were included in this retrospective study. The median age of repair was 16 days (range, 3 days$\~$23.7 months) and the mean weight was $3.62\;\pm\;1.30 kg$. Thirty one $(68.9\%)$ had coarctation and 14 $(31.1\%)$ had interrupted aortic arch. Associated intracardiac anomalies were VSD in 31 patients (VSD group), TGA or Taussig-Bing anomaly in 10 (TGA group), and others in 4 (ASD in 1, aortopulmonary window 1, truncus arteriosus 1, aortic and mitral stenoses 1, miscellaneous group). The arch obstruction was repaired with end-to-side anastomosis in 23 patients and end-to-end anastomosis in 22. Result: Overall postoperative hospital mortality was $22.2\%\;(10/45);\;16.1\%$ (5/31) in VSD group, $40\%$ (4/10) in TGA group, and$25\%$ (1/4) in miscellaneous group. There was no mortality in VSD group since 1998, and the mortality in TGA group has remarkably reduced since technical modification for coronary transfer was adopted $(75\%\;vs\;16.7\%)$. There was no postoperative seizure or other neurological complications. Postoperative aortic restenosis occurred in 5 patients $(5/35,\;14.3\%)$. Two patients underwent balloon aortoplasty with successful results. There was no reoperation. There was one late death caused by pneumonia 5 months after the operation. Two-year actuarial survival rate including operative death was $72.9\%$. Conclusion: The operative mortality of one-stage repair has been reduced with time and aortic restenosis rate was also acceptable. We concluded that this procedure is a reproducible procedure for aortic arch anomalies associated with intracardiac defects.

Deepest Dormancy Period in Strawberry 'Reiko' and Time for Starting Insulation in Semi-forcing With Lighting in Daegu Area ('여홍' 딸기의 대구지방 휴면최심기와 반촉성 보온개시기)

  • Lee, Woo-Sung;Mun, Jong-Hak;Kim, Seung-Ki;Lee, Ha-Yoon
    • Horticultural Science & Technology
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    • v.19 no.4
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    • pp.488-494
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    • 2001
  • Seedlings of strawberry, 'Reiko' were planted in plastic pots of 24 cm in diameter in the middle of September in 1995, 1996, and 1997. Ten plants were transferred to greenhouse with artificial illumination at 5-day interval from late September to late January. The deepest dormancy of 'Reiko' in Daegu area was found to be on November 5, October 25, and October 31 in 1995, 1996, and 1997, respectively. The time for moving plants to make the plants grow in semi-dormant state in the greenhouse occurred between Nov. 10 and Nov. 20 in both 1995 and 1996, and between Nov. 10 and Nov. 30 in 1997. The time passing approximately 100-200 cumulative hours of exposure to below $5^{\circ}C$ canopy temperature from the peak dormancy, which is required for breaking dormancy of 'Reiko', was between November 16 and 25 in 1996, and November 24 and December 5 in 1997. 'Reiko' yielded high every year when seedlings were moved into greenhouse during the period of October to November. The plants gave good response to forcing culture under lighting. The right time for moving plants into greenhouse in semi-forcing culture appeared to be the time passing 50-150 cumulative hours of exposure to below $5^{\circ}C$ canopy temperature from the peak dormancy.

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Scintigraphic Assessment of Myocardial Viability (신티그라피에 의한 심근생존능 평가)

  • Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.155-160
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    • 1993
  • The identification of viable myocardium in patients with coronary artery disease and left ventricular dysfunction is an issue of increasing clinical relavance in the current era of myocardial revascularization. There are at least two forms of reversible myocardial dysfunction. Early reperfusion does not always lead to immediate functional improvement; rather, the return of contractility in tissue salvaged by reperfusion is delayed for hours, days or even weeks, a phenomenon that has been termed "stunned myocardium". Some patients with coronary artery disease show myocardial dysfunction at rest which are associated with reduced perfusion, and which disappear after revascularization; this phenomenon has been termed "hibernating myocardium". Recently, cardiac imaging techniques that evaluate myocardial viability on the basis of perfusion-contraction mismatch and inotropic reserve have gained substantial popularity and clinical success. This review focus on the application of $^{201}TI$ and $^{99m}Tc-MIBI$ to address myocardial viability in patients with hibernating and stunned myocardium. It is clear that 4-hour redistribution images of $^{201}TI$ underestimate ischemia and overestimate scar. Delayed imaging and reinjection imaging have been developed for the assessment of viability. Among many protocols suggested, stress-redistribution-reinjection imaging gained most popularity. Although $^{99m}Tc-MIBI$ could identify myocardial viability, $^{201}TI$ reinjection technique was regarded as superior to it. In conclusion, $^{201}TI$ stress, 4-hr rest redistribution, and reinjection imaging technique may be the most preferable method for evaluation of myocardial viability.

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Role of Adenosine and Protein Kinase C in the Anti-ischemic Process of Ischemic Preconditioning in Rat Heart (허혈전처치의 허혈심장 보호과정에서 Adenosine 및 Protein Kinase C의 역할)

  • You, Ho-Jin;Park, Jong-Wan;Kim, Myung-Suk
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.31-37
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    • 1996
  • The protective effect of 'ischemic preconditioning (IP)'on ischemia-reperfusion injury of heart has been reported in various animal species, but the mechanism is unclear. In an attempt to elucidate the mechanism of IP, we examined the effects of blockers against adenosine and protein kinase C in preconditioned heart of rat. The hearts perfused with oxygen-saturated Krebs-Henseleit solution by Langendorff method were exposed to 30 min global ischemia followed by 20 min reperfusion. IP was performed with three episodes of 5 min ischcmia and 5 min reperfusion just before ischemia-reperfusion. IP prevented the depression of contractile function and the myocardial contracture in the ischemic-reperfused heart and reduced the release of lactate dehydrogenase during the reperfusion period. Polymyxin B, chelerythrine and colchicine, PKC inhibitors, attenuated almost completely the anti-ischemic effect of IP, while adenosine receptor antagonists did not. These results indicate that PKC may be a crucial intracellular mediator in anti-ischemic action of IP in ischemic-reperfused rat heart, while adenosine may not be involved in the mechanism of IP.

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