• Journal of Chest Surgery
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• v.25 no.4
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• pp.412-417
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• 1992

Pulmonary artery aneurysm is Behcet`s disease is rare and can be fatal due to rupture. We experienced a case of pulmonary artery aneurysm in Behcet`s disease. The patient was 21 year old woman who was adimitted with three month history of dyspnea, fever and cough. On examination, she had aphthous ulcer in the mouth and erythema nodosum on the left popletial fossa and forearm, but didn`t have any lesion at eyes and genitalia. The latex fixation test for rheumatoid factor, VDRL test for syphillis, antinuclear antibody and LE cell test were all negatives. The third and fourth components of complement in the serum, serum immunoglobulin concentrations[IgG, IgM, IgA] were within normal range. The chest radiography revealed a 5x6cm sized radiopaque mass density in the left hilar region. Two months later, the mass was enlarged to 6x7cm. The IV-DSA showed a single aneurysm at the proximal part of left lower lobe artery with lingular segment artery and no distal perfusion by thombotic obstruction. The steroid therapy was done for a month, but symptoms not improved. We performed resection of lingular segment and lower lobe including the aneurysm. The microscopic findings of the operative specimen were intimal hyperplasia and fragmentation of the internal elastic fibers. She was improved without remarkable event, except infection of the operative wound.

• Clinical and Experimental Pediatrics
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• v.56 no.4
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• pp.186-190
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• 2013

Lung torsion is a very rare event that has been reported in only 9 cases in the pediatric literature but has not yet been reported in Korean infants. We present a case of lung torsion after tracheoesophageal fistula repair in an infant. Bloody secretion from the endotracheal tube and chest radiographs and computed tomographic scan results indicated lung torsion. Emergency exploration indicated $180^{\circ}$ torsion of the right upper lobe (RUL) and right middle lobe (RML). After detorsion of both lobes, some improvement in the RUL color was observed, but the color change in the RML could not be determined. Although viability of the RML could not be proven, pexy was performed for both the lobes. Despite reoperation, clinical signs and symptoms did not improve. The bronchoscopy revealed a patent airway in the RUL but not in the RML. Finally, the RML was surgically removed. The patient was discharged on the 42nd day after birth.

• Korean Journal of Adult Nursing
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• v.26 no.5
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• pp.573-583
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• 2014

Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.822-825
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• 2002

The paravalvular leak after redo mitral prosthetic valve replacement is rare but serious complication when it does happen. This condition should be corrected surgically to increase life span and improve symptoms. But simple closure or patch closure of paravalvular leak are not effective in cases of weak annulus or broad defect. We report 3 cases of trido mitral valve replacement using mechanical valve with its sewing ring expanded by a collar of Dacron sheet. The prosthetic sewing ring is anchored on the weak mitral annulus with multiple interrupted sutures, while the Dacron collar is contineuously sutured to the left atrial wall for blood tight sealing. All of the three cases showed event free postoperative course.

• Korean Journal of Veterinary Service
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• v.39 no.2
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• pp.93-99
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• 2016

The anesthetic depth and cardiovascular effect of alfaxalone constant rate infusion in dogs premedicated with xylazine or acepromazine were evaluated. Ten dogs were randomly allocated into 2 groups. In group AA, dogs were premedicated with 0.02 mg/kg of intravenous acepromazine at 15 min before induction. In group XA 1.1 mg/kg of intravenous xylazine was premedicated at 5 min before induction. The anesthesia was maintained with 6 mg/kg/hr of alfaxalone after induction with 2 mg/kg alfaxalone in both groups. In both of groups, the qualities of induction were satisfactory without any adverse event, but adequate analgesia could not be provided, according to the withdrawal test. $PaO_2$ and $SaO_2$ implied a slight hypoxemia state in XA group, while those values of group AA were not significantly changed. The acepromazine and alfaxalone combination induce mild tachycardia. The bispectral index score were significantly decreased in group XA, compared with that in group AA. The premedication of xylazine before alfaxalone constant rate infusion in this study could provide adequate analgesia during 30 min, while the premedication with acepromazine could not.

• Journal of Chest Surgery
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• v.25 no.1
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• pp.57-65
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• 1992

St.Jude Medical cardiac valve replacement was performed in 322 patients: 191 had mitral, 58 had aortic, 72 had double valve and 3 had tricuspid valve replacement. Motality rate in early period was 2.8%[9 patients]. The most common cause of early death was low cardic output syndrome. Follow up extended from 1 to 90 months[mean: 34 months] in 292 patients among 313 in all surviving patients [93.6%]. There were thrombolic complications in eighteen patients. The probability of free from thromboembolism at 5 yerars in MVR, AVR and DVR were 84.7%, 91.8% and 90.2% respectively. And also, actuarial event free rate at 5 years in MVR, AVR and DVR were 80.1%, 82.2%, and 81.4% respectively. There were fourteen late death during follow up period: six from thromboembolism, one from hemorrhage and the others from non valve related -or unknown complications. The acturial survival rate at 5 years were 93.1% in mitral, 92.1% in aortic and 97.1% in double valve replacement. In conclusion, the performance of the St. Jude Mecanical valve compares most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.464-469
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• 1986

Pulmonary atresia with intact ventricular septum, and with VSD were uncommon congenital anomalies with high mortality in the neonatal period. Those survivals depend on an adequate interatrial communication or interventricular communication and pulmonary flow via large aortopulmonary collateral including PDA. Recently we experienced surgical correction of 2 cases pulmonary atresia with intact ventricular septum and with VSD. On case 1, 10-years old male patient was confirmed as pulmonary valvular membranous atresia with intact ventricular septum combined with large functioning PFO and mild tricuspid incompetence. So we performed total correction under the E.C.C, that was PDA ligation, RVOT reconstruction with monocusp valved outflow patch [16mm], repair of tricuspid insufficiency and closure of PFO. Post-operative hemodynamic result was good and there was no event during hospital course. On case 2, 16-years old female patient was diagnosed as pulmonary atresia with VSD and PDA. MPA was absent, remained fibrous cord like remnant and type of VSD was subaortic defect [3cm by 3cm in the size]. PDA was located at the usual site. Under the E.C.C. VSD patch closure through the right ventriculotomy, anastomosis between the right ventricular outflow tract and the pulmonary bifurcated site with the extra-cardiac Hancock valved conduit [22cm] and PDA ligation were performed.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.676-680
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• 2000

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.

• Archives of Pharmacal Research
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• v.29 no.1
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• pp.1-15
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• 2006

Vascular endothelial cell injury or dysfunction has been implicated in the onset and' progression of cardiovascular diseases including atherosclerosis. A number of previous studies have demonstrated that the pro-oxidative and pro-inflammatory pathways within vascular endothelium play an important role in the initiation and progression of atherosclerosis, Recent evidence has provided compelling evidence to indicate that interleukin-4 (IL-4) can induce proc inflammatory environment via oxidative stress-mediated up-regulation of inflammatory mediators such as cytokine, chemokine, and adhesion molecules in vascular endothelial cells. In addition, apoptotic cell death within vascular endothelium has been hypothesized to be involved in the development of atherosclerosis. Emerging evidence has demonstrated that IL-4 can induce apoptosis of human vascular endothelial cells through the caspase-3-dependent pathway, suggesting that IL-4 can increase endothelial cell turnover by accelerated apoptosis, the event which may cause the dysfunction of the vascular endothelium. These studies will have a high probability of revealing new directions that lead to the development of clinical strategies toward the prevention and/or treatment for individuals with inflammatory vascular diseases including atherosclerosis.

• Journal of Chest Surgery
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• v.2 no.2
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• pp.141-146
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• 1969

The importance of bronchial occlusion which occurs in the natural course of tuberculosis as an inconstant but very fortunate event became obscured with the popularity of resection therapy for pulmonary tuberculosis and the resectional surgery and thoracoplasty are the standard method of surgical procedure in the treatment of pulmonary tuberculosis. However in some cases of far advanced pulmonary tuberculosis, the need for another surgical methods arise when standard method is not indicated under the consideration of poor pulmonary function or operative and postoperative complications such as bronchial fistula. The ligation and division of bronchus draining the involved part of the lung is one of the applicable method among the another surgical procedures. The authors experienced one case of far advanced pulmonary tuberculosis who had a huge cavity in the right upper lobe and a small cavity in the superior segment accomanying with several nodular densities in the basal segment and contralateral left lung field, and treated with right upper lobectomy, ligation and division of the superior segmental bronchus and concomitant rib-resectional thoracoplasty in order to prevent postoperative bronchial fistula and to preserve maximal lung function. The postoperative course was smooth without complication regarding to bronchial ligation and division technique and the general condition has been excellent without symptoms. The postoperative sputum examination for AFB on smear and culture has been negative during the 11 month period of follow up, and X-ray of the chest including tomography demonstrated no evidence of residual cavity indicating succesful collapse of cavity.