• Title/Summary/Keyword: Chest Support

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Right Heart Support in OPCAB -2 cases Report- (우심실 보조장치 하의 심장박동 상태에서 시행한 관상동맥 우회수술 -2례 보고-)

  • 조석기;김기봉
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.906-909
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    • 2000
  • 심폐바이패스를 사용하지 않고 심장박동 상태에서 시행하는 관상동맥 우회수술은 심 비대와 좌심실 기능저하가 동반된 협증심 환자에서는 심장 뒤쪽에 위치한 관상동맥에 대한 접근이 어렵고 수술 중 혈역학적으로 불안정하여 시행하기에 어려운 경우가 많다. 우심실 보조장치 하의 심장박동 상태에서 시행하는 관상동맥 우회수술은 대동맥의 삽관을 피하고, 심폐바이패스의 합병증을 줄일 수 있으며, 심장 뒤쪽에 위치한 혈관의 문합시에도 안정된 혈역학적 상태를 유지 할 수 있어 고위험군 환자에게 도움을 줄 수 있다. 좌심실 기능저하와 심 비대가 동반된 환자에서 우심실 보조장치 하의 심장박동 상태에서 시행한 관상동맥 우회수술을 2례 시행하여 좋은 결과를 얻어 보고하고자 한다.

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Surgical Treatment of Post-Infarction Ventricular Septal Defect with Left Ventricular Rupture -A Case Report- (심근 경색후 발생한 좌심실 파열을 동반한 심실중격 결손의 외과적 치료 -1례 보고-)

  • Kim, Hyun-jo;Kim, Doo-Sang;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.857-860
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    • 1995
  • In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

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Surgical Management of Chronic Pulmonary Embolism - Surgical treatment and perioperative problems - (만성 페색전증의 외과적 요법수술 및 수술 전후 문제)

  • 김응수
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.139-147
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    • 1987
  • in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

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Two chambered right ventricle with anomalous trabecular hypertrophy (이강 우심실 1례 보고)

  • Gwak, Mun-Seop;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.34-39
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    • 1983
  • The syndrome of anomalous muscle bundle dividing the right ventricle into two pressure chambers has been described by many authors. The malformation should not be confused with tetralogy of Fallot itself because the obstructive hypertrophic bands are usually proximal to the right ventricular infundibulum. One case [11 years old male] of double chambered right ventricle due to aberrant muscle bundle with intact ventricular septum is presented. The pressure gradient was 68 mmHg between inflow and outflow tracts of right ventricle on cardiac catheterization. On opening the right ventricle, there noted stenosis of outflow tract by infundibular membrane, hypertrophied anomalous muscle bundle, thickened moderator band & hypertrophied anterior papillary muscle. Open heart surgery was carried out with the aid of extracorporeal support, Anomalous muscle bundle [1.0 cm x 4.0 cm] and infundibular membrane were resected safely. The hypertrophied moderator band was cut at mid-portion and anterior papillary muscle was split vertically. The postoperative course was uneventful and discharged in good condition 2 weeks later.

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Treatment of Drug Susceptible Pulmonary Tuberculosis

  • Shin, Hong-Joon;Kwon, Yong-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.161-167
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    • 2015
  • Tuberculosis (TB) remains a major global health problem, and the incidence of TB cases has not significantly decreased over the past decade in Korea. The standard short course regimen is highly effective against TB, but requires multiple TB-specific drugs and a long treatment duration. Recent studies using late-generation fluoroquinolones and/or high-dose rifapentine-containing regimens to shorten the duration of TB treatment showed negative results. Extending the treatment duration may be considered in patients with cavitation on the initial chest radiograph and positivity in sputum culture at 2 months of treatment for preventing TB relapse. Current evidence does not support the use of fixed-dose combinations compared to separate drugs for the purpose of improving treatment outcomes. All patients receiving TB treatment should be monitored regularly for response to therapy, facilitation of treatment completion, and management of adverse drug reactions. Mild adverse effects can be managed with symptomatic therapy and changing the timing of the drug administration, but severe adverse effects require a discontinuation of the offending drugs.

Whole Lung Irradiation for Metastatic Lung Malignancy (전이성 폐암의 전폐 방사선치료)

  • Chung, Tae-Soo
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.87-92
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    • 1984
  • The author reviewed four cases of multiple lung metastases who were treated by whole lung irradiation alone for palliation. All patients tolerated the treatment well without complication. Two patients who had symptoms from pulmonary metastases had subjective relief of symptoms and all four patients had objective regression of lung metastases on repeat chest X-rays. Present report and review of literature support that some selected patients with multiple lung metastases can be benefited by whole lung Irradiation. However, systemic chemotherapy should be main modality of treatment for this kind of disseminated disease whenever possible.

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Acute Massive Pulmonary Embolism - A Case Report - (급성 폐동맥 색전증의 치험 1례)

  • Jun, Tae-Gook;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.811-815
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    • 1990
  • Successful emergency pulmonary embolectomy with the cardiopulmonary bypass was performed in a 41 \ulcorneryear old male who suffered massive pulmonary embolism after longterm bed rest due to the injury of left knee. Temporary cardiopulmonary bypass provided 120 minutes of circulatory support while complete removal of bilateral pulmonary emboli accomplished using Forgarty catheter and Gall stone forceps. Also, manual compression of the lungs was necessary to remove distal branching emboli. The patient had smooth and uneventful hospital course without complications and discharged from hospital taking coumadine on the 13th day after the operation.

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Siphonochilus aethiopicus, a traditional remedy for the treatment of allergic asthma

  • Fouche, Gerda;van Rooyen, Schalk;Faleschini, Teresa
    • CELLMED
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    • v.3 no.1
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    • pp.6.1-6.6
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    • 2013
  • Asthma is a chronic inflammatory disease of the lungs, characterized by increased sensitivity to bronchoconstriction associated with infiltration of immune cells and mucus hyper secretion. In South Africa, the indigenous plant Siphonochilus aethiopicus, is used by traditional health practitioners to treat colds and flu, wheezing of the chest, coughs, influenza, sinus problems and mild asthma. In this study we aimed to investigate the potential anti-inflammatory and immune-modulating properties of S. aethiopicus in vitro. The dried and powdered S. aethiopicus plant material was extracted with organic solvents. The dried extracts were screened in vitro in the transcription response, NF-${\kappa}B$ and a cytokine assay. Significant activity was observed for organic extracts of the plant in these assays. This study provides evidence that S. aethiopicus has anti-inflammatory and immune-suppressing properties in vitro. These findings may support anecdotal accounts of its effectiveness against allergic asthma.

Preoperative Extracorporeal Membrane Oxygenation for Severe Ischemic Mitral Regurgitation - 2 case reports -

  • Kim, Tae-Sik;Na, Chan-Young;Baek, Jong-Hyun;Kim, Jae-Hyun;Oh, Sam-Sae
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.236-239
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    • 2011
  • Indication for extracorporeal membrane oxygenation (ECMO) has been extended as the experience of ECMO in various clinical settings accumulates and the outcome after ECMO installation improves. We report two cases of successful mitral valve surgery for severe ischemic mitral regurgitation in patients on ECMO support for cardiogenic shock which developed upon coronary angiography.

Postintubation tracheal stenosis -One case report- (기관협착증 -1예 보고-)

  • Jo, In-Taek;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.470-474
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    • 1986
  • In the treatment of the acute respiratory failure, ventilatory support with endotracheal intubation or tracheostomy is a life saving procedure in many cases but the development of postintubation tracheal stenosis is a very serious complication. Recently we have experienced one case of postintubation tracheal stenosis which occurred in the region of cuff site. Preoperative tracheogram showed a concentric stricture 3.0 cm in length located 4.0 cm proximal to the carina. Under the general anesthesia, the stenotic segment was resected and end-to-end anastomosis was performed successfully through the right posterolateral thoractomy. Her postoperative course was uneventful and the patient has remained well till now.

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