• Journal of Chest Surgery
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• 제36권6호
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• pp.431-435
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• 2003

개심술 후 발생하는 심부 흉골 창상감염(급성 종격동염)은 아주 심각한 합병증으로 높은 이환율, 사망률, 그리고 입원기간의 연장을 보인다 치료 결과는 주로 흉골 창상감염의 조기 진단과 적절한 외과적 조치에 의존한다. 개심술 후 심부 흉골 창상감염을 보였던 4예에서 광범위한 변연절제술, 항생제 용액의 높은 압력 하 세척, Robicsek방식에 의한 흉골의 재 고정, 항생제 용액을 사용한 세척-흡입법을 통해 성공적인 치료를 하였기에 문헌 고찰과 함께 보고한다.

• Journal of Chest Surgery
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• 제21권5호
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• pp.889-893
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• 1988

We experienced a case of infective endocarditis of aortic valve and tricuspid valve associated with a fistula between aorta and right ventricle. The patient was 35 years old woman and showed severe congestive heart failure. Large and multiple vagetations were found on the valvular surfaces and a fistula was present between aorta and right ventricle. Probably infective endocarditis of aortic valve resulted in annular abscess and as it healed, a fistula was formed and tricuspid valve endocarditis followed. We replaced the aortic valve and tricuspid valve with St. Jude mechanical prostheses, and closed the fistula opening with suture. The postoperative course was smooth and the patient has no problems till now 4 months after operation.

• Journal of Chest Surgery
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• 제27권9호
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• pp.793-797
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• 1994

Constrictive pericarditis is often accompanied with ~brothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective symptoms. We experienced 4 cases of constrictive pericarditis combined with bilateral ~brothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time through anterolateral thoracotomy with sternal transection[3 patients] and median sternotomy incision[l patient]. Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive retraction for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right atrium, SVC and IVC.

• Journal of Chest Surgery
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• 제27권9호
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• pp.759-763
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• 1994

Between November 1990 and December 1993, 9 patients underwent surgical intervention for acute active endocarditis at Gyeongsang National University Hospital. All the patients were operated on within the first six weeks after onset of symptoms for various reasons. Surgical indications for early surgery were heart failure, systemic septic emboli, new murmur and growing vegetation. Most common infecting organism was Staphylococcus[55 %], and the others were Streptococcus, anaerobes, Candida and unknown in 1 case. The infection was in the mitral valve in 5 patients, the aortic valve in 2, the aortic and mitral in 1, and the aortic and pulmonary in 1. There was one operative death[11 %] and no late death. Preoperative Functional Class were II in 4 patients, III in 5 and after surgery all the patients improved to Class I. We conclude that early surgical intervention in acute active endocarditis is effective in most instances.

• Journal of Chest Surgery
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• 제35권8호
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• pp.605-607
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• 2002

Harmonic Scalpel(Echicon Endo-Surgery Cincinnati, OH)은 초음파를 이용하여 근육자극이 전혀 없으며, 열이나 연기가 적게 나며, 지혈도 쉽고, 수술시야가 좋아서 수술에 많은 이점을 가지고 있다. 교착성 심막염 환자에서 심막절제술을 시행할 때 Harmonic Scalpel을 사용하여 도움이 되었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제36권10호
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• pp.784-788
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• 2003

Swyer-James증후군은 침범된 폐의 폐동맥의 발육부전과 폐기종을 나타내어 흉부 단순 사진상 일측성 과투시성을 특징으로 하는 드문 폐쇄성 세기관기염의 한 종류이다. 저자들은 Swyer-James증후군에 침범되지 않은 정상 폐측에 병발한 기관지원성 편평 상피세포암의 임파절 곽청술과 함께 우상엽 절제술을 시행, 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제33권5호
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• pp.440-444
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• 2000

A 54-year-old male patient was admitted due to dyspnea with chest pain and reddish swelling in the right lteral neck and right upper which developed 2 or 3 days age. He was treated with acupuncture in the neck about one week ago prior to admission. CT scans of the chest showed density of air and abnormal soft tissue which suggested abscess of the anterior mediastinum and subcutaneous tissue. He underwent cervical and mediastinal drainage with closed thoracostomy and antibiotic therapy. Black-pigmente anaerobic nonspore-forming gram-negative bacilli were isolated from the mediastinal pus and were identified as Prevotella intermedia/nigrescens upon performing biochemical tests and API rapid ID 32A (bioMeriux, France) kit. He underwent decortication of the right side because of loculated empyema on 41st postoperative day. He was fully recovered and discharged on the 82nd hospital day. This was thought to be another case of descending necrotizing mediastinitis not caused by peritonsilar abscess but by cellulitis developed after acupuncture. Early deterction of mediastinits and aggressive drainage of mediastinal abscess are important.

• Journal of Chest Surgery
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• 제17권2호
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• pp.263-268
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• 1984

Four patients of acute purulent pericarditis were seen at the Jeonbug National University Hospital between January, 1979 and December 1983. All patients were proven to have acute purulent pericarditis by clinical evaluation, bacterial study, and biopsy. Three patients were male and one female. The three patients were in pediatric age. The primary focuses were meningitis, Rt. coxitis, lobar pneumonia, and gastro-enteritis. The causative organisms were staphylococcus aureus in two patients. In the other two patients, organisms were not cultured from the pericardial pus. The reason why the causative organisms were not cultured in pericardial pus was probably due to massive antimicrobial treatment before pus collection. All patients were treated with systemic antibiotic therapy and pericardiostomy with normal saline irrigation. The three patients were treated without specific complication. The one patient developed the chronic constrictive pericarditis. In this patient, pericardiectomy was performed.

• Journal of Chest Surgery
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• 제20권1호
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• pp.171-176
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• 1987

Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and its major branches. Symptoms and signs of the disease are various depending on the involved area. We experienced a surgical case of Takayasu`s arteritis mainly involving both renal arteries with renovascular hypertension in a 13 year old girl. Hypertension was not controlled by medical treatment including diuretics and captopril [160/140 mmHg]. Aortogram showed severely stenosed right renal artery, nearly obstructed left renal artery and not visulalized superior mesenteric artery. Angioplasty was performed for the right renal artery but aorta-renal bypass graft with greater saphenous vein was inevitable for the left renal artery. Blood pressure was controlled sufficiently with some adjunct of captopril postoperatively [130/90 mmHg]. While the patient was discharged with much improvement, she was lost follow up and died of not identified definitive cause 3 months later.

• Journal of Chest Surgery
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• 제11권3호
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• pp.273-280
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• 1978

19 chronic pericarditis patients reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 10 years from January of 1968 to January of 1978. 2. There were 14males and 5 females in this series. Range of age varied from 110 days to 61 years. 2. There were two hospital death, one expired 2 days and another 3 days after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factor. 2. Clinical and histological study showed tuberculous origin in 8 cases, nonspecific chronic inflammatory changes in 6 cases and pyogenic infection cases in 5 patients. 2. The postoperative complications were observed in 6 cases, and the most common was cardiac arrhythmia and wound infection. 2. The extent of pericardiectomy should be confined to the left and right ventricles to correct the hemodynamic anomaly in general. The results of this procedure has been satisfactory in 89 percent of the cases. 2. Optimal myocardial function in cases of constritive pericarditis was the key to the successful outcome of this procedure.