• Journal of Chest Surgery
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• 제28권9호
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• pp.865-868
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• 1995

A case of bronchogenic cyst associated with a partial pericardial defect is reported. Bronchogenic cysts are not so rare in incidence, but they are more rare when associated with a pericardial defect, the first case being reported by Rusby and Sellors in 1945. Recently, we experienced such a rare case of a bronchogenic cyst with a partial pericardial defect. The patient is a 39-year-old female and she was found to have a left anterior mediastinal mass during routine chest X-ray. During the operation, we detected partial pericardial defect after removal of the mediastinal mass. The pericardial defect was repaired with a Gore-Tex Membrane. The pathological examination of the mass showed a bronchogenic cyst. The patient had an uneventful hospital course.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1049-1051
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• 1999

We performed a reoperation of failed tricuspid mechanical valve in a 63-year-old female patient because the overgrown endothelial pannus had entrapped the prosthetic leaflets. Four years ago, the patient underwent mitral and tricuspid valve replacements with 31 and 33 mm Carbomedics, respectively. The patient showed symptoms of neck vein distention, abdominal distention and peripheral edema. The chest film, echocardiography and cineangiography confirmed the diagnosis of tricuspid valve. During the operation, we found the entrapped leaflets of the tricuspid valve in a partially closed state and the endothelial pannus had overgrown into the leaflets. Carpentier-Edward bovine pericardial valve was inserted and the patient was discharged with no significant events.

• Journal of Chest Surgery
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• 제20권1호
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• pp.177-181
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• 1987

For the treatment of bronchial stenosis due to trauma, inflammatory and neoplastic lesion, bronchoplastic procedure in the interest of preservation of lung tissue are relatively new developments in the field of thoracic surgery. We reported on case of bronchoplasty using to pericardial patch for the treatment of bronchial stenosis due to chronic inflammation. The patient was 26 years old female and chief complaint was respiratory difficulty. Bronchogram revealed diffuse stenosis of left main bronchus about 4cm and especially, at just below the carina marked narrowing of lumen and fine serration in the wall. At the time of operation, longitudinal incision was made at left main bronchus about 5cm and reconstructed bronchus using to pericadial patch at membranous compartment of bronchus. The postoperative course was uneventful and post-operative follow up bronchography showed that improvement of bronchoplastic segmented region.

• Journal of Chest Surgery
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• 제16권1호
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• pp.49-54
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• 1983

Fifty-Seven Cases of tricuspid valve replacement were done from April 1976 to January 1983. Fourteen congenital and 43 acquired cases were found. In 13 cases tricuspid valve alone was replaced with 2 operative deaths and one late deaths. In 35 cases TVR and MVR were done with 6 operative deaths and 6 late deaths. In 9 cases TVR, MVR, and AVR were done with one operative deaths. Over all operative mortality was 15.8% and late mortality 12.3% among the 48 survivors. Over all Survival rate was 71.9% during follow-up period ranging from 8 months to 6 years and 9 months. In every case TVR was done with bioprosthetic xenograft valves.

• Journal of Chest Surgery
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• 제31권12호
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• pp.1230-1233
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• 1998

The Cox-Maze procedure was developed as a cure for atrial fibrillation. The recovery rate of both atrial contractility is reported low in the atrial fibrillation associated with mitral valvular heart disease than that of loan atrial fibrillation. We performed the Cox-Maze procedure (Maze III) in three cases who suffered from non-mitral heart diseases associated with atrial fibrillation: A ruptured sinus of Valsalva aneurysm, a ventricular septal defect, and an aortic stenoinsufficiency. The Cox-Maze procedure was performed concomitantly with correction of the underlying heart disease. Conversion to sinus rhythm was achieved in all three patients, and both right and left atrial mechanical activities could be identified echocardiographically after three postoperative months.

• Journal of Chest Surgery
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• 제32권2호
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• pp.198-200
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• 1999

탄산 음료수병에 녹아있던 탄산 가스의 팽창 압력에 의한 식도의 천공은 드물게 보고된다. 이러한 환자를 구강 및 인후의 손상만으로 진단하고 식도 손상을 간과한다면 환자에게는 치명적인 결과를 가져오게 된다. 조기 진단과 적절한 수술적인 중재를 해야만 환자를 구할 수 있게 된다. 조기 진단이 가능하려면 환자의 병력과 이학적 검사로 식도의 천공을 예측해야 한다. 저자들은 탄산 음료가 들어있는 병 입구를 입에 물고 있다가 폭발적 막\ulcorner기화하여 팽창하는 압력에 의해 식도의 천공이 유발된 2례의 증례를 보고한다.

• 월간당뇨
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• 통권151호
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• pp.18-19
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• 2002

당뇨병 환자에서 고혈압은 미세혈관 및 대혈관 합병증을 촉반 혹은 악화시킬 수 있으므로 임상적으로 매우 중요하다. 당뇨병 환자에서 사망의 원인은 주로 대혈관 합병증인 관동맥심장질환, 심비대, 울혈성 심부전증, 뇌졸중, 말초혈관 질환 등의 심혈관계 및 뇌혈관계 질환때문이며, 당뇨병이 없는 사람에 비해 이들 질환의 빈도는 2$\~$6배나 높다. 고혈압도 심혈관계 및 뇌혈관계 독립인자로서 당뇨병 환자에서 고혈압이 동반되면 각각을 동반할 때보다 이들 질환의 발생 위험도는 훨씬 높아진다. 이들 질환에 의한 사망률 증가뿐 아니라 당뇨병의 미세혈관 합병증인 망막증과 신증의 발생률이 고혈압을 동반할 때 증가하며, 특히 기존의 신증 혹은 망막증의 진행은 고혈압이 나타나면 촉진된다. 임상적으로 더욱 중요한 사실은 이러한 고혈압을 치료함으로써 이들 합병증의 진행을 지연시키거나 막을 수 있다는 것이며, 이미 당뇨병성 신증환자에서 고혈압 치료의 효과가 밝혀져 있다. 따라서 당뇨병 환자에서 고혈압을 반드시 조기에 확인하여 적극적으로 치료하여야 한다.

• Journal of Chest Surgery
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• 제28권6호
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• pp.579-582
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• 1995

The extended transseptal approach to the mitral valve replacement has been used for 30 patients. There were 19 women and 11 men. Twenty five patients had rheumatic heart disease, 4 had degenerative valve ,and 1 had valve prolapse. Fifteen of 30 patients had other associated procedure; 10 had aortic valve replacement; 5 had tricuspid annuloplasty. There were no postoperative complications associated with the approaches, ie, no bleeding, no sinus node dysfuction, and no atrioventricular conduction disturbance. Despite division of the sinus node artery, preoperative atrial rhythms[3 sinus rhythms and 27 atrial fibrillations were not changed during postoperative period. The extended transseptal approach provides good mitral valve exposure without inherent complications, and is superior to that of standard approach, so we use it routinely for mitral valve procedure.

• Journal of Chest Surgery
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• 제12권2호
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• pp.127-134
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• 1979

During the 4 years period to be reported, 34 operations were performed on the mitral valve in the department of Thoracic and cardiovascular surgery, Korea University hospital, from Aug. 1975 to April 1979. At the first 1-year period, the closed technique was used in 12 patients. After that, open-heart surgery was used routinely; 8 patients had open mitral commissurotomy and 14 patients had valve replacement. There were 18 men and 16 women with sex ratio of 1.1: 1. The age of the patients varied widely from 18 years of the youngest to 46 years of the oldest-average aged of 32.5 years. All had symptoms and the mean duration of symptoms was 6 years and 1 month. Preoperative atrial fibrillation was 47% and embolizations were in 3 of 34 patients. The operative mortality was none for the closed and 14% for the open technique combined rate of 9 per cent which were valve thrombosis, brain embolism and left pulmonary vein rupture in deauriculization. But surviving patients undergoing open heart surgery enjoyed symptomatic benefits comparable to these of the patients of closed.

• Journal of Chest Surgery
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• 제26권2호
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• pp.102-107
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• 1993

Human atria play an important role in extracellular homeostasis through release of atrial natriuretic peptide. To evaluate the relationship between plasma level of atrial natriuretic peptide (ANP) and many changes which can develop during extracorporeal circulation, we studied 16 patients undergoing, 12 cardiac operation and 4 thoracic operation. Plasma level of ANP in cardiac patients group was significantly higher and more changeable than thoracic patients group. After aortic cross clamp release, blood was filled at right atrium and right atrial pressure was rapidly increased. At the same time, plasma level of ANP was rised suddenly. Increase of ANP level was correlated (p<0.05) with the increase of total bypass time, but was not correlated statistical with aortic cross clamp time. ANP level did not fall rapidly after aortic cross clamp while both atria were completely empty. This result was explained by intraoperative hypothermia at that time, which can inactivate plasmal endopeptidase and catalytic receptors of ANP. The ANP level of atrial fibrillation group in cardiac patients were generally higher than normal sinus group, but there was no statistical correlation.