• Title/Summary/Keyword: Cardiovascular event

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Total Cavo Pulmonary Shunt: Report of two cases (총대정맥-폐동맥 단락술 수술치험 2례)

  • Park, Cheol-Hyeon;Lee, Sin-Yeong;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1263-1269
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    • 1990
  • Two patients with uncorrectable cyanotic cardiac anomalies underwent total cavopulmonary shunt[modified Fontan operation]. Case I was a 14 years old male with dyspnea and cyanosis after birth. Aortogram showed TGA combined with overriding of aorta, pulmonary stenosis, complete atrioventricular septal defect, interruption of inferior vena cava, and situs inversus totalis. We had performed total cavopulmonary shunt using with 16 mm Gortex Graft in single atrium to bypass the hepatic vein to pulmonary artery. Postoperatively, patient sustained low PaCO2 and low cardiac output and then expired at 19th postoperative day. The cause of death of the patient would be low cardiac output. Case II was a 6 years old female with dyspnea and cyanosis after birth. Aortogram showed tricuspid atresia[Type IIb], transposition of great arteries, atrial septal defect, ventricular septal defect and pulmonary stenosis, We had performed total cavo-pulmonary shunt using intraatrial baffle[tunnel] with Goretex patch. The postoperative course of this patient was good without event.

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Surgical Treatment for Acute Caustic Injury of the Hypopharynx, Esophagus, and Stomach -Two Cases- (하인두 및 위의 손상을 동반한 급성 부식성 식도손상의 외과적 치료)

  • Kim, Hyeong-Gon;Lee, Sam-Yun;Choe, Jong-Beom
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.935-938
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    • 1995
  • Two cases of severe caustic injury of the hypopharynx, esophagus, and stomach are presented. Restoration of digestive continuity was accomplished by retrosternal isoperistaltic interposition of the transverse and left colon on the post-injury 73rd and 66th day respectively. The upper oro-colon continuity was made by a cervical approach, a vertical incision at the posterior hypopharyngeal wall, and interrupted one-layer sutures using 3-0 Dacron suture materials. The distal continuity was made by colojejunostomy between the transposed colon and proximal jejunum. There was no event after the operation in both cases. The posterior vertical hypopharyngotomy and hypopharyngocolostomy at the early post-injury period may be the preferred procedure to obtain normal deglutition in patients with esophageal stricture associated with hypopharyngeal injury.

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체외순환중 발생한 대량 공기전색에 대한 상공대정맥을 통한 일시적역관류 -치험 2예-

  • 이재성
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.543-548
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    • 1986
  • Massive air embolism during cardiopulmonary bypass is uncommon but serious and often lethal complication. Following this catastrophic event, the immediate institution of retrograde arterial blood perfusion via superior vena cava was made to remove air emboli from cerebral circulation. This method was performed by removing the arterial perfusion line from aortic cannula and connecting it to superior vena caval cannula. Then, retrograde perfusion at a flow rate of 2Umin via superior vena cava was carried out for 3 minutes. After air returning from the aortic cannula was identified, each line was connected to the cannulae primarily. In 2 cases who had massive air emboli due to air pumping into arterial line, the postoperative complete recovery resulted from this technique, which was used in conjunction with other therapy postoperatively.

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DEVS/CS Combined Model Approach for the Cardiovascular System (심혈관 시스템의 DEVS/CS 혼합 모델링)

  • Cho, Yong-Jae;Jeon, Gye-Rok;Lee, Kwon-Soon;Chang, Yong-Hoon;Lee, Sang-Yeol
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.05
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    • pp.87-91
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    • 1995
  • Combined models, specified by two or more modeling formalisms, can represent a wide variety of complex systems. This paper describes a methodology for the development of combined models in two model types of discrete events and continuous process. The methodology is based on transformation of continuous state space into discrete one to homomorphically represent dynamics of continuous processes in discrete events. As an example, a combined model of human heart is developed which Incorporates conventional differential equation formalism with Zeigler's DEVS(Discrete Event Specification System) [4]formalism.

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Inhibitory Effects of PD98059, SB203580, and SP600125 on α-and δ-granule Release and Intracellular Ca2+ Levels in Human Platelets

  • Kwon, Hyuk-Woo
    • Biomedical Science Letters
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    • v.24 no.3
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    • pp.253-262
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    • 2018
  • Platelets are activated at sites of vascular injury via several molecules, such as adenosine diphosphate, collagen and thrombin. Full platelet aggregation is absolutely essential for normal hemostasis. Moreover, this physiological event can trigger circulatory disorders, such as thrombosis, atherosclerosis, and cardiovascular disease. Therefore, platelet function inhibition is a promising approach in preventing platelet-mediated circulatory disease. Many studies reported the involvement of mitogen-activated protein kinases (MAPKs) signaling pathways in platelet functions. However, these studies were limited. Thus, we examined MAPK signaling pathways in human platelets using specific MAPK inhibitors, such as PD98059, SB203580, and SP600125. We observed that these inhibitors were involved in calcium mobilization and influx in human platelets. They also suppressed thrombin-induced ${\alpha}$- and ${\delta}$-granule release. These results suggest that PD98059, SB203580, and SP600125 exhibit $Ca^{2+}$ antagonistic effects.

Plastic Reconstruction of Tuberculous Bronchostenosis with Rib Cartilage (결핵성 기관지협착 환자에 있어서 늑연골을 이용한 기관지성형술 치험 1례 보고-)

  • Kim, Ju-Hyeon;Lee, Yeong-Tak
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.782-786
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    • 1988
  • We experienced plastic reconstruction of tuberculous bronchostenosis with patient`s rib cartilage. He suffered from coughing and sputum for 2months, and was treated for pulmonary tuberculosis 10 years ago. In preoperative bronchoscopy, left main bronchus was fibrotic obstructive and LUL bronchus was severely destructed. After thoracotomy, we harvested the rib cartilage at the 6th rib, and designed semicircular and tubular graft. And then onlayed the graft over the longitudinal bronchotomy site by simple interrupted sutures with 4-0 Vicryl Postoperative course was good, coughing and sputum disappeared. In postoperative bronchoscopy, the patch graft was good in that position, and the internal diameter was sufficient, but the granuloma was found in the stoma of LUL bronchus. He was discharged without any other event.

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Robotic Intraoperative Tracheobronchial Repair during Minimally Invasive 3-Stage Esophagectomy

  • Marano, Alessandra;Palagi, Silvia;Pellegrino, Luca;Borghi, Felice
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.154-157
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    • 2021
  • Tracheobronchial injury (TBI) is an uncommon but potentially fatal event. Iatrogenic lesions during bronchoscopy, endotracheal intubation, or thoracic surgery are considered the most common causes of TBI. When TBI is detected during surgery, concomitant surgical treatment is recommended. Herein we present a case of successful robotic primary repair of iatrogenic tracheal and left bronchial branch tears during a robot-assisted hybrid 3-stage esophagectomy after neoadjuvant chemoradiotherapy. A robotic approach can facilitate the repair of this injury while reducing both the potential risk of conversion to open surgery and the associated increased risk of postoperative respiratory complications.

Simultaneous Bilateral Spontaneous Pneumothorax (동시에 발생한 양측성 자발성 기흉)

  • Kim Eung-Soo;Sohn Sang-Tae;Kang Jong-Yael
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.475-478
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    • 2006
  • Background: The simultaneous bilateral spontaneous pneumothorax is a rare clinical event. Contrary to the unilateral pneumothorax, the patients with simultaneous bilateral spontaneous pneumothorax sometimes complains of severe respiratory distress, cyanosis and chest pain without tention pneumothorax. It is often dangerous; therefore, the chest drain should be inserted immediately. Material and Method: Between March 1994 and February 2004, 802 patients were treated in our department for spontaneous pneumothorax. Among these, the simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%). Result: Out of fourteen patients, two females and twelve males presented with simultaneous bilateral spontaneous pneumothorax. The patient age ranged between 0 and 79 years with mean age of 31.2 years. In eleven patients, this was the first episode of pneumothorax. One patient had combined hemopneumothorax and two patients had combined pyopneurnothorax. Six patients had smoking history (42.8%, average 17.3 p-y). Five patients had pulmonary tuberculosis history and among these, two patients had active pulmonary tuberculosis. Three patients were died due to meconium-aspiration pneumonia (1 patient) and ARDS (Acute Respiratory Distress Syndrome) with pneumonia (2 patients). We treated these patients with nasal oxygen inhalation, chest drain insertion, thoracotomy, VATS (Video-Assisted Thoracoscopic Surgery) and chemical pleurodesis. Conclusion: The simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%) among 802 patients. Prompt insertion of chest drain is needed for a relief of severe symptoms, and to reduce the risk of recurrence, early thoracotomy or VATS should be performed rather than chest drain insertion only.

Feasibility of the Threshold-Based Quantification of Myocardial Fibrosis on Cardiac CT as a Prognostic Marker in Nonischemic Dilated Cardiomyopathy

  • Na Young Kim;Dong Jin Im;Yoo Jin Hong;Byoung Wook Choi;Seok-Min Kang;Jong-Chan Youn;Hye-Jeong Lee
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.540-549
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    • 2024
  • Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

Ribosomal protein S3 is phosphorylated by Cdk1/cdc2 during G2/M phase

  • Yoon, In-Soo;Chung, Ji-Hyung;Hahm, Soo-Hyun;Park, Min-Ju;Lee, You-Ri;Ko, Sung-Il;Kang, Lin-Woo;Kim, Tae-Sung;Kim, Joon;Han, Ye-Sun
    • BMB Reports
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    • v.44 no.8
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    • pp.529-534
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    • 2011
  • Ribosomal protein S3 (rpS3) is a multifunctional protein involved in translation, DNA repair, and apoptosis. The relationship between rpS3 and cyclin-dependent kinases (Cdks) involved in cell cycle regulation is not yet known. Here, we show that rpS3 is phosphorylated by Cdk1 in G2/M phase. Co-immunoprecipitation and GST pull-down assays revealed that Cdk1 interacted with rpS3. An in vitro kinase assay showed that Cdk1 phosphorylated rpS3 protein. Phosphorylation of rpS3 increased in nocodazole-arrested mitotic cells; however, treatment with Cdk1 inhibitor or Cdk1 siRNA significantly attenuated this phosphorylation event. The phosphorylation of a mutant form of rpS3, T221A, was significantly reduced compared with wild-type rpS3. Decreased phosphorylation and nuclear accumulation of T221A was much more pronounced in G2/M phase. These results suggest that the phosphorylation of rpS3 by Cdk1 occurs at Thr221 during G2/M phase and, moreover, that this event is important for nuclear accumulation of rpS3.