• Journal of Chest Surgery
• /
• 제36권6호
• /
• pp.422-426
• /
• 2003

심장에 발생하는 원발성 악성종양의 발생빈도는 아주 낮게 보고되고 있으며, 국내의 증례보고도 미미한 수준이다. 29세 남자 환자가 최근 2개월간 점증되는 심계 항진과 운동 시 호흡곤란으로 본원 심장내과에 내원하여 검사를 진행하던 중에 심초음파상에 좌심방내의 종괴가 발견되어 좌심방점액종으로 진단하고 긴급수술로 개심술하에 종양절제술을 시행하였다. 수술소견에서 35$\times$90$\times$50 mm의 점액성 종양의 기저부가 광범위하게 좌심방후벽과 우상폐정맥의 입구로 침윤되어 있었으며 단순박리로 종양은 절제되었으나 좌심방후벽과 우상폐정맥,그리고 좌하폐정맥의 입구의 종양의 침윤을 육안으로 확인하였다. 수술 후 병리조직 검사 결과 악성 점액섬유성육종으로 진단되었다. 환자는 수술 후 18일째에 경쾌 퇴원하였으며, 수술 후 방사선치료와 6차례의 항암제 치료를 진행하여 술 후 10개월 간 추적 관찰에서 재발이나 전이의 소견 없이 잘 생활하고 있다.

• Journal of Chest Surgery
• /
• 제37권3호
• /
• pp.228-234
• /
• 2004

원발성 심종양은 비특이적 증상을 호소하고 매우 드물게 발생하는 질환이다. 악성 종양과 양성 종양으로 구분되며 외과적 절제술과 부가적인 치료를 필요로 한다. 1995년 3월부터 2003년 3월까지 원발성 심종양으로 진단받은 21예의 환자들을 대상으로 하였다. 이 환자들을 대상으로 수술 전후의 여러 가지 인자들과 수술 후 조기 및 만기 성적에 대한 후향적 연구를 진행하였다. 6예는 남자, 15예는 여자였으며 그들의 평균 연령은 45.44$\pm$18.76세였다. 병리학적 검사 결과 21예 중에서 18예는 양성(14예의 점액종, 2예의 섬유탄력종, 1예의 혈관종, 1예의 부신경절종), 3예는 악성(1예의 혈관 육종, 1예의 중피종, 1예 점액섬유육종)종양이었다. 1예의 수술 사망이 관찰되었고, 혈관종, 중피종과 혈관육종의 경우 근치적인 수술이 불가능한 상태에서 술 후 부가적인 치료와 외래 추적 중에 사망하였다. 원발성 심종양의 치료에 있어서 수술적 치료가 중요하며 경우에 따라서 부가적인 치료도 중요하지만 악성의 결과 예후는 불량하다.

• Journal of Chest Surgery
• /
• 제12권1호
• /
• pp.33-42
• /
• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Journal of Chest Surgery
• /
• 제21권2호
• /
• pp.351-365
• /
• 1988

During one year[1987], 110 cases of open heart surgeries were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje Medical College. And the results were summarized as follows. 1. Among the 110 cases, there were 77 cases of congenital heart diseases and 33 cases of acquired heart diseases. Age range of the congenital patients was 8 months to 30 years with the mean age of 8 years, and acquired patients was 16 to 56 years with the mean age was 32 years. 2. The heart lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 50 of membrane type and 60 of bubble type. For all cases GIK[glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 77 congenital anomalies, there were 67 cases of acyanotic patients[ASD: 12, VSD: 50, PS: 1, AP window: 1, Gerbode defect: 1, ECD: 2] and 10 cases of cyanotic patients[TOF: 10], and to all of which the appropriate radical operations were applied. 4. Among the 33 acquired diseases, there were one case of left atrial myxoma, one of annuloaortic ectasia, 20 of mitral valve diseases[MS: 2, MSr: 8, MR: 2, MRs: 8], 9 of double valve diseases[MRs+AR: 1, MRs+ARs: 2, MRs+TR: 1, MSr+TR: 3, MSr+ASr: 1, MSr+ARs: 1], 2 of triple valve diseases[MSr+AR+TR: 1, MSr+ASr+TR: 1]. The left atrial myxoma was removed well with right atriotomy and atrial septal approach. And to the annuloaortic ectasia, Bentall operation was applied with good result. Mitral valve replacement[MVR] was applied to 20 cases of mitral valve diseases, double valve replacement[MVR+AVR] was applied to 6 cases of double valve diseases, MVR & tricuspid annuloplasty[TVA] was applied to 3 cases of mitral 5. The number of replaced valve were 39 in 31 cases. In MVR, 5 of mechanical valves[St. Jude Medical Valve] and 26 of tissue valves[Carpentier-Edward valve] were used. In AVR, 3 of mechanical valves and 5 of tissue valves were used. 6. Postoperative complications were occurred in 23 cases, and among them 21 cases were recovered with intensive cares, but 2 cases were expired[mortality: 1.8%].

• Journal of Chest Surgery
• /
• 제39권11호
• /
• pp.810-814
• /
• 2006

배경: 심장에 발생하는 종양은 흔치 않다. 심장종양의 종양에 대한 임상적 특징과 수술 결과를 조사하였다. 대상 및 방법: 1990년 3월부터 2005년 12월까지 35명(남자14명, 여자 21명)의 환자를 대상으로 하였으며 평균 나이는 52.4세였다. 임상 및 병리학적 조사를 후향적으로 시행하였다. 수술은 좌심실 섬유종 1예를 제외한 전 예에서 완전 절제술을 시행하였다. 결과: 양성은 30예였으며 그중 점액종이 29예, 섬유종이 1예였다. 악성은 5예로 골육종, 미분류 점액성 육종, 간세포암, 신세포암, 그리고 난황낭암이 각 1예였다. 양성인 경우 수술 사망은 없었으며 완전절제 후 추적이 가능했던 27예의 경우 재발된 예는 없었다. 악성의 경우 4예가 술 후 6개월 이내에 사망하였다. 결론: 좌심방의 점액종이 가장 많았으며 양성의 경우 외과적 치료는 효과적이었으나 악성인 경우 예후는 매우 불량하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제47권2호
• /
• pp.112-119
• /
• 2021

Objectives: Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity. Materials and Methods: Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated. Results: In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the follow-up period. Conclusion: Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.

• 대한두경부종양학회지
• /
• 제40권1호
• /
• pp.55-58
• /
• 2024

Myxoma is a locally invasive neoplasm usually involving the jaw bones, typically occurs between the second and fourth decades. This tumor may comprise 3%-6% of odontogenic tumors. Myxomas of the soft tissue of the face are very rare. We present an unusual case of myxofibroma occurring in a 13-year-old man involving the soft tissue of the face. It congenitally occurred and was a 1 cm sized, ovoid in shape, swelling located on the glabella without any symptoms. An excisional biopsy was performed. A well encapsulated ovoid mass was attached to the corrugator supercilli muscle below the frontalis muscle. It was measured 1.1 × 1 × 0.8 cm and completely excised. Histological examination revealed myxofibroma showing stellate and spinde-shaped cells throughout myxoid ground substance. The unusual features of this case are the site of the tumor, which was localized to the non-tooth bearing area of the mandible and its congenital occurrence history.

• Journal of Chest Surgery
• /
• 제38권4호
• /
• pp.301-307
• /
• 2005

원발성 심장 종양은 비교적 드문 질환으로 알려져 있다. 저자들은 수술을 시행받은 원발성 심장 종양의 결과에 대하여 살펴보았다. 대상 및 방법: 1980년 8월부터 2003년 12월까지 연세심장혈관 병원에서 원발성 심장 종양으로 수술을 시행 받은 86명의 환자들을 대상으로 병리적 진단에 따라 점액종, 점액종외의 양성 종양 및 악성 종양으로 나누어 고찰하였다. 환자들의 평균 연령은 $44.3\pm20.8$세였으며 남자가 29명$(33.7\%)$ 여자가 59명$(66.3\%)$이었다. 수술 후 병리적 진단으로는 양성 종양이 81예$(94.2\%)$였고 이 중 점액종이 70예$(78.7\%)$로 가장 많았으며 섬유종이 5예$(5.6\%)$, 횡문근종이 3예$(3.4\%)$였고, 악성 종양은 5예$(5.8\%)$였다 결과: 점액종은 양성 종양의 $86.4\%$였고 환자들의 평균 나이는 $50.4\pm15.4\;(7\~80)$세였다. 여자가 49명$(70\%)$이었으며 가장 흔한 증상은 호흡 곤란$(62.9\%)$이었다. 종양은 57예$(81.4\%)$에서 좌심방 중격에 위치하였고, 우심실 중격에 위치한 1예를 제외하고는 모두 완전 절제가 가능하였다. 수술 사망은 얼었으며 1예에서 수술 후 승모판막 부전이 발생하여 승모판막 대치술을 시행 받았다. 평균 추적 관찰 기간은 $109.3\pm71.8$개월이었고 이 기간 중 종양의 재발 소견을 보인 환자는 없었다. 점액종외의 양성 종양은 11예$(12.8\%)$로 섬유종이 5예, 횡문근종이 3예였다. 2예에서 진균성 심내막염 및 저산소증으로 인한 수술 사망이 있었으며 재수술은 없었다. 악성 종양은 5예$(5.8\%)$로 미분화성 육종이 2예, 횡문근육종 1예 등이었고, 수술 사망은 없었으나 추적이 가능했던 3예에서 합병증에 의한 사망이 있었다. 걸론: 점액종은 완전 절제 후 예후가 매우 좋았으며, 점액종외의 양성 종양은 증상 완화에 도움이 되었다. 악성종양은 종양과 관련된 증상을 완화시키기 위하여 수술이 필요하였으나 예후는 불량하였다.

• Journal of Chest Surgery
• /
• 제13권4호
• /
• pp.394-404
• /
• 1980

During the period of June 1976 October 1980 131 cases of Open heart Surgery was performed at the National Medical Center in Seoul under the extracorpocal circulation. 77 cases were congenital heart disease and 54 were acquired heart disease. The age of the patients ranged between 2$\frac{1}{2}$ and 51 years. For all patients partial hemodilution technique and moderte hypothermia was used during extracorporeal circulation and cardioplegia was done for myocardial protection since April 1978. 41 of congenital cases were non-cyanotic group and 1 case died. 36 of congenital cases were cyanotic group and revealed very high mortiality rate (16 death, 39%). 53 of acquired cases were cases of valvular heart disease, 34 mitral (3 death), 1 aortic, 4 mitral with aortic 12 mitral with tricuspid (3 death), 2 triple valves (2 death), and revealed mortality rate of 15.1% (8 death). 1 of acquired cases were left atrial myxoma. There were 25 cases of operative death and over all motality rate was 19.1%.

• Journal of Chest Surgery
• /
• 제17권2호
• /
• pp.305-314
• /
• 1984

From May 1977 to April 1984, 204 cases of open heart surgery were performed under cardiopulmonary bypass. There were 99 male and 105 female patients ranging in age from 19 months to 58 years. 136 cases [66.7%] were congenital heart disease, and 68 cases [33.3%] were acquired heart disease, which were 66 valvular disease [97.1%], 1 IVC obstruction, and 1 myxoma. There were 136 congenital heart anomaly with 16 operative deaths [11.8%], consisting of 94 acyanotic cases with 7 death [7.4%] and 42 cases of cyanotic cases with 9 deaths [21.4%]. In 66 patients of acquired valvular disease, 52 valves were implanted; 47 mitral valve replacement with 4 death [8.5%] and 5 double valve replacement [MVR+AVR] with 1 death [20%]. Postoperative, warfarin sodium was medicated with checking prothrombin time. Finally, the operative mortality was 11.8% in congenital anomaly, and 11.8% in acquired heart disease, overall mortality rate was 8.5%.