• IMMUNE NETWORK
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• 제9권3호
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• pp.106-113
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• 2009

Background: We previously demonstrated remarkable differences in the expression of IL-8/CXCL8 in aortic tissues and vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHR) compared to VSMC from normotensive Wistar-Kyoto rats (WKY). In the present study, we investigated the direct effect of IL-8/CXCL8 on expression of 12-lipoxygenase (LO), a hypertensive modulator, in SHR VSMC. Methods: Cultured aortic VSMC from SHR and WKY were used. Expression of 12-LO mRNA was determined by real-time polymerase chain reaction. Phosphorlyation of ERK1/2 and production of 12-LO and angiotensin II subtype 1 ($AT_1$) receptor were assessed by Western blots. IL-8/CXCL8-stimulated DNA synthesis was determined by measuring incorporation of [$^3H$]-thymidine. And effect of IL-8/CXCL8 on vascular tone was determined by phenylephrine-induced contraction of thoracic aortic rings. Results: Treatment with IL-8/CXCL8 greatly increased 12-LO mRNA expression and protein production compared to treatment with angiotensin II. IL-8/CXCL8 also increased the expression of the $AT_1$ receptor. The increase in 12-LO induced by IL-8/CXCL8 was inhibited by treatment with an $AT_1$ receptor antagonist. The induction of 12-LO mRNA production and the proliferation of SHR VSMC by IL-8/CXCL8 was mediated by the ERK pathway. The proliferation of SHR VSMC and the vascular contraction in the thoracic aortic ring, both of which were induced by IL-8/CXCL8, were inhibited by baicalein, a 12-LO inhibitor. Conclusion: These results suggest that the potential role of IL-8/CXCL8 in hypertensive processes is likely mediated through the 12-LO pathway.

• Journal of Chest Surgery
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• 제30권7호
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• pp.656-662
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• 1997

대동맥판막 질환에 대한 판막 성형술이 판막 치환술의 대치 방법으로 대두되고 있는 가운데, 서을 대학교 병원 흉부외과에서는 1995년 3월부터 1996년 8월까지 14명의 환자에서 자가 심낭 편을 이용한 판막첨 연장 술로 대동맥 판막성형술을 시행하였다. 평균 연령은 34.8$\pm$15.3세이었으며, 남자가 11명, 여자가 3명이었다. 수술전 시행한 심초음파 검사 및 심도자 검사에서 협착증을 동반하지 않은 대동맥판막 폐쇄부전증 환자로 폐쇄부전 정도는 평균 3.4$\pm$0.65였으며, 이중 4명의 환자에서 중등도 이상의 승모판 폐쇄부전증을 동반하고 있었다. 수술은 0.625% glutaraldehyde 용액에 15분간 고정시킨 자가 심낭 편을 이용하였으며, 12명의 환자에 서는 세 개의 판막첨을 모두 연장시켜 주었으나, 2명의 환자에서는 상대적으로 짧은 판막의 판막첨만을 연장 시켜 주었으며, 승모판 폐쇄부전증을 동반한 4명에서 승모판 성형술을 동시에 시행하여 주었다. 14명 모두에 서 수술중 경식도 심초음파 검사를 시행하여 폐쇄부전이나 협착이 없는 것을 확인하였다. 수술 후 평균 7.4 $\pm$2.1일에 심초음파 검사를 시행하였으며, 경도의 대동맥판막 폐쇄부전이 3명에서 나타 돛만\ulcorner 승모판 성형 술을 시행한 환자 중 1명에서 경한 정도의 승모판 폐쇄부전이 나타났다. 좌심실의 수축기말과 확장기말 구획 은 수술 후 통계적으로 유의한 정도(p<0.05)의 감소를 보였다. 수술 직후의 사망 환자는 없었다. 수술 후 평균 7.9$\pm$5.9개월간 추적 조사 기간 중 만기 합병증은 2명에서 나타났다. 심내막염 및 대동맥 판막의 증식물이 수술 후 7개월 째 발견되어 대동맥 판막 치환술을 시행 받은 환자가 1명 있었으며, Behcet증후군 환자에서 수술 후 3개월 째 갑작스런 대동맥판막 폐쇄부전증이 나타나 Ross수술을 받은 환자가 1명 있었다. 대동맥 판막의 판막첨 연장술의 조기 성적은 만족할 만한 결과를 보였으며, 특히 젊은 연령의 폐쇄부 전증 환자에서 판막치 환술의 대치술로 우수한 것으로 판단된다. 그러나 자가 심방편의 비후,석회화,또는 파열 등의 내구성에 대한 오랜 기간의 추적 검사가 필요하리라 본다.

• Journal of Chest Surgery
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• 제20권2호
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• pp.261-269
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• 1987

From 1976 through 1986, authors have experienced 127 cases of peripheral vascular surgery which had been done in this department. There were 29 cases of atherosclerosis obliterances including 7 Leriche syndrome, 32 Buerger`s diseases, 25 arterial thromboembolisms, 21 vascular injuries, 2 peripheral arterial aneurysms, 2 renovascular hypertensions, 1 congenital A-V malformation, 13 varicose vein of lower extremities, and 2 Jugular venous ectasia. Cases with vena caval disease and aortic disease were excluded. The mean age of ASO and Buerger`s disease was 56.1 yrs, 33.8 yrs respectively. The male to female ratio showed marked male preponderance [27:2, and 30:2], and almost every male patient was smoker. The indication of operation was similar in both disease entities. The method of operation for ASO were bypass procedure [17], thromboendarterectomy [6], and lumbar sympathectomy [5], and for Buerger`s disease were mainly sympathectomy and few bypass procedures and amputations. Seventeen patients with ASO were followed from 3 to 75 month and overall patency rate for bypass or endarterectomy in one and two months and 2 1/2 yr were 93%, 87%, and 31% respectively. Post operatively patient`s symptoms was relieved or alleviated in almost ASO patients, and about 60% of Buerger`s disease. We concluded that in patient with ischemic limb, we must revascularized aggressively for symptomatic relief. And choice of graft for bypass procedure was to be evaluated further.

• Journal of Chest Surgery
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• 제22권6호
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• pp.894-900
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• 1989

It has been suggested that mixed venous $O_{2}$ tension is a predicor of cardiac output especially in a critically ill patient after an open heart surgery. From April 1988 through September 1989, we monitored mixed venous $O_{2}$ tension and pulmonary arterial pressure in 48 patients with acyanotic congenital heart disease at postoperative 1 hour, 6 hour, 12 hour, 24 hour, and 48 hour respectively. They were divided into Group I, with severe pulmoary hypertension, and Group II, without severe pulmonary hypertension. In Group I, mixed venous $O_{2}$ tension and cardiac index showed significant increase with time (p<0.05), but the ratio of pulmonary-aortic systolic pressure didn't show significant change. The increase was significant only 24 hour after operation, and so this low cardiac performance in early postoperative period should be considered when postoperative management is being planned in the risky patient. In Group II, all of the three variables didn't show any significant change with time. The correlation coefficient between mixed venous $O_{2}$ tension and cardiac index was significantly different from zero in both Group I (p<0.001) and group II (p<0.05) at each imeperiod, but the ratio of pulmonary-aortic systolic pressure didn't correlated well with the other 2 variables. Our study showed that serial determination of mixed venous $O_{2}$ tension in acyanotic congenital heart disease could be used as a guide in estimating the cardiac index postoperatively.

• Journal of Chest Surgery
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• 제30권1호
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• pp.92-96
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• 1997

구강 생식기의 궤양, 안구와 피부 병변을 특징으로 하는 베체씨 병의 예후는 중추 신경계, 위장관, 혈 관계의 합병증에 의존된다. 심장의 병변 특히 대동맥 판막 폐쇄부전증은 매우 드물고, 일반적으로 혈역 학적 불안정성은 개심술을 통하여 치료된다. 그러나 많은 환자에서 인공 판막의 이탈, 판막 주변 누출. 전도 장애, 가성 동맥류 등의 심각한 합병증이 보고되어 왔다. 이런 합병증을 막기 위하여 많은 노력이 있었으며 그중 하나는 동종 이식편읜 사용이었다. 서울대학교병원 흉부외과에서는 베체씨 대동맥염으로 인해 인조 판막 이탈이 있었던 39세 남자 환자에서 동종 이식편을 이용한 대동맥 근위부 치환술을 시도하여 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제43권5호
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• pp.490-498
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• 2010

배경: 대동맥궁 분지 혈관의 해부학적 외 우회로술(extra-anatomic bypass)과 흉부 혈관내 대동맥 스텐트 도관 삽입술을 같이 시행하는 하이브리드 술식은 고식적인 완전 개방 수술에 비해 덜 침습적이며, 스텐트 도관 삽입술 시 안정된 안착지점(landing zone)을 확보할 수 있는 장점을 가지는 것으로 알려져 있다. 저자들은 본원에서 시행된 하이브리드 술식의 중단기 성적에 대하여 알아보고자 하였다. 대상 및 방법: 2008년 8월부터 2010년 1월까지 흉부대동맥 질환의 치료를 위해 하이브리드 술식을 시행한 일련의 환자들을 대상으로 하였다. 환자의 수술 전 후 데이터는 전향적으로 수집하였으며, 평균 추적관찰 기간은 $10.8{\pm}5.5$개월(3~20개월)이었다. 결과: 9명의 환자(남:여=7:2)에서 하이브리드 술식이 시행되었으며, 평균 나이는 $63.8{\pm}15.8$세 (38~84세)였다. 5명에서 대동맥궁 혹은 근위 하행대동맥류가 있었으며, 2명의 환자에서 하행대동맥에 박리성 동맥류가, 2명에서 상행 대동맥, 대동맥궁, 및 하행대동맥에 광범위한 동맥류가 관찰되었다. 수술 전, logistic EuroSCORE로 계산한 평균 예측사망률은 21%였다. 6명에서 상행 대동맥으로부터 대동맥궁 분지혈관으로 탈분지화 및 재혈관화를 시행하였으며, 2명에서 경동맥-경동맥 우회로술, 1명에서 경동맥-액와동맥 우회로술을 시행하였다. 평균 수술 시간은 $221.4{\pm}84.0$분(94~364분)이었다. 수술 후 100%의 환자에서 전산화 단층 혈관촬영을 통하여 스텐트 도관의 성공적인 안착을 확인하였으며, 총 평균재원일수는 $15.2{\pm}4.6$일이었다. 수술 후 사망은 없었다. 1명에서 우측 안동맥 분지에 색전증이 발생하였고 이외 합병증은 없었다. 추적관찰 기간 중 1명에서 스텐트 근위부의 endoleak으로 재시술을 시행하였으며, 20개월 생존율은 100%이었다. 결론: 흉부대동맥 질환의 치료에 있어 하이브리드 술식은 덜 침습적이고 효과적인 치료이다. 본 연구의 중단기 성적을 토대로 보아 하이브리드 술식은 고무적인 치료법으로 사료된다.

• Journal of Chest Surgery
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• 제49권3호
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• pp.165-170
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• 2016

Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

• Journal of Chest Surgery
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• 제17권3호
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• pp.389-397
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• 1984

Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.

• 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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• 제22권6호
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• pp.996-1000
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• 1989

Open heart surgery begun at 1959 in Korea. From that time to 1979, the surgery was performed below 100 cases in a year. However,that was performed above, 1,000 cases in a year from 1981. During the recent three years, i.e., 1985, 1986, and 1987, the annual operative cases were 3614,4503, and 4906, and then the mortality rates were progressively decreased to 6.2%, 5.3 %, and 5.0 %. In these time, overall mortality rate above 1 year old was 5.0 % versus that below 1 year old 17.9 9o in congenital heart diseases. These results are statistically different between two groups. Of the valvular heart disease cases, which occupied 97 % of total acquired heart disease, individual incidence was in mitral 68 %, and aortic 28%. The operative method was mainly valve replacement. Operative mortality for valve surgery in total was 4.4 %. Until 1985, bioprosthetic valve was frequently implanted but mechanical valve has been done more frequently in these days. Coronary artery bypass graft was large portion [67 * 75 %] of open heart surgery in western, but was below 1 % in Korea. However our diet patterns have been changed. Therefore we think the incidence of coronary artery disease will be increased. So we will be familiar to this field.