• Journal of Chest Surgery
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• 제35권11호
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• pp.812-816
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• 2002

심낭삼출은 결핵 등의 감염성 질환, 악성 신생물, 개심술, 요독증 등 다양한 병변들로 인해 발생되며 이에 대한 진단 및 치료적 방법으로서 심낭천자술 및 심낭막 개창술 등이 시행되고 있다. 최근 비디오 흉강경술(VATS)은 심낭삼출을 비롯한 흉강내 여러 질환에 대해서 새로운 효과적인 수술방법으로 각광받고 있다 개흉술시의 제한적 수술시야를 비디오 흉강경으로서 극복할 수 있다는 점, 심낭막 및 심낭내 병변에 대한 전체적 관찰이 용이하고 수술 후 통증이 적다는 점, 미용적 효과와 재원 기간의 단축 등이 그 이유이다. 울산대학교 서울아산병원 흉부외과에서는 1995년 3월부터 2001년 8월까지 심낭막 개창술을 시행한 환자 55례에서 VATS로 시행한 40례 중 기존 상병의 악화로 30일 이상 흉관을 거치한 3례를 제외한 37례(A군)와 개흉술 15례 중 1례를 제외한 14례(B군)를 구분하여 수술시간, 흉관 거치기간, 재발율 및 재원기간 등을 비교 고찰하였다. A군은 남자18명, 여자19명이었으며 나이는 20세부터 80세까지 평균 56.4세였고 B군은 남자 8명 여자 6명으로 나이는 34세에서 77세까지 평균 58.4세였다. A군의 수술 시간은 18분부터 155분까지 평균 61.2분이었으며 흉관제거는 수술 후 2일부터 24일 까지 평균 9.3일만에 제거하였고 재발율은 2.7%였으며 재원기간은 5일에서 39일까지 평균 16.2일이었다. B군의 수술시간은 30분부터 100분까지 평균 58.4분이었고 흉관 제거는 수술 후 6일에서 28일 까지 평균 12.2일만에 제거하였고 재발율은 7.1%였으며 재원기간은 8일에서 34일 까지 평균 17.3일이었다. 통증의 정도는 술 후 진통제를 근주 및 정주 한 횟수로 비교해 볼 때 A군은 평균 4.2회 B군은 평균 6.3회로 A군에서 더 진통제의 사용이 적었다. 평균 재원 기간, 흉관 거치기관을 비교해 볼 때 비디오 흉강경술의 경우에서 짧았으나 두 군간의 유의한 차이는 보이지 않았다. 수술시간 및 재발율 또한 두 군간에 유의한 차이를 보이지 않았다. 본 저자들은 심낭삼출의 치료로서 비디오 흉강경술은 안전하고 입원기간, 흉관 거치기간, 통증의 정도가 적으며 피부 창상이 적어 개흉술을 대치할 수 있다고 사료된다.

• Journal of Chest Surgery
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• 제44권3호
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• pp.247-249
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• 2011

We report a case of pseudo-pseudoaneurysm, which is a very rare complication of myocardial infarction. A 69-year-old man was admitted to our clinic with chest tightness and dyspnea. He had undergone aortic valve replacement with a pericardial bioprosthetic valve, ring mitral annuloplasty, and reconstruction of an aortic annular defect due to infective endocarditis with bovine pericardium 4 years prior. Echocardiography and computed tomography showed pericardial effusion and a 16-mm cavity at the anterolateral wall of the left ventricle. Magnetic resonance imaging suggested either pseudo-pseudoaneurysm or myocardial abscess. We successfully repaired the myocardial defect using a patch made from a vascular graft with pledgeted horizontal mattress sutures under cardiopulmonary bypass.

• 대한영상의학회지
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• 제85권1호
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• pp.197-203
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• 2024

결핵성 심막염은 폐외 결핵으로 나타나는 질환으로 대부분 심막 비후, 심막 삼출과 석회화를 동반한다. 우리는 77세 남성에서 발견된 악성 심막 종양으로 오인된 결핵성 심막염에 대해 보고하려 한다. CT상 불규칙적이고 결절성 심막 비후로 관찰된 병변은 MRI T1 지방 억제 영상에서 고신호강도 및 테두리 조영증강을 보였다. 비특이적 영상 소견을 보이는 결핵성 심막염의 경우 MRI가 감별진단에 도움이 될 수 있다.

• Tuberculosis and Respiratory Diseases
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• 제47권2호
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• pp.265-271
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• 1999

저자들은 전에 증상이 없던 환자에서 돌발적인 흉통과 호흡곤란이 발생하고, 단순흉부사진상 종격동 종괴와 좌흉막유출을 보여 종격동 기형종의 흉막강내 파열의 기능성을 고려했다. 진단이 쉽지 않은 급성증상에 대해 다른 흔한 흉곽내 질환들과의 감별진단이 필요했으며, 흉막강천자상 편평상피세포와 모발을, 흉부 단층촬영사진상 지방밀도를 포함한 다양한 밀도를 가진 종격동 낭성종괴를, 초음파유도 경피적 세침흡인술상 무핵의 편평상피를 포함한 무균성의 양성 낭성병변을 확인했다. 이러한 임상적, 세포학적, 방사선학적 검사소견으로 수술 전에 종격동 기형종의 흉막강내 파열을 진단할 수 있었으며, 본 증례에서는 측정되지 못했지만, 낭종액와 흉막유출액의 amylase 측정은 이러한 진단을 지지할 수 있을 것으로 생각된다.

• Journal of Chest Surgery
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• 제46권6호
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• pp.426-432
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• 2013

Background: Heart transplantation has become a widely accepted surgical option for end-stage heart failure in Korea since its first success in 1992. We reviewed early postoperative complications and mortality in 239 patients who underwent heart transplantation using bicaval technique in Asan Medical Center. Methods: Between January 1999 and December 2011, a total of 247 patients aged over 17 received heart transplantation using bicaval technique in Asan Medical Center. After excluding four patients with concomitant kidney transplantation and four with heart-lung transplantation, 239 patients were enrolled in this study. We evaluated their early postoperative complications and mortality. Postoperative complications included primary graft failure, cerebrovascular accident, mediastinal bleeding, renal failure, low cardiac output syndrome requiring intra-aortic balloon pump or extracorporeal membrane oxygenation insertion, pericardial effusion, and inguinal lymphocele. Follow-up was 100% complete with a mean follow-up duration of $58.4{\pm}43.6$ months. Results: Early death occurred in three patients (1.3%). The most common complications were pericardial effusion (61.5%) followed by arrhythmia (41.8%) and mediastinal bleeding (8.4%). Among the patients complicated with pericardial effusion, only 13 (5.4%) required window operation. The incidence of other significant complications was less than 5%: stroke (1.3%), low cardiac output syndrome (2.5%), renal failure requiring renal replacement (3.8%), sternal wound infection (2.0%), and inguinal lymphocele (4.6%). Most of complications did not result in the extended length of hospital stay except mediastinal bleeding (p=0.034). Conclusion: Heart transplantation is a widely accepted option of surgical treatment for end-stage heart failure with good early outcomes and relatively low catastrophic complications.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권5호
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• pp.432-440
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• 2022

Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m². Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m² vs. 16.06± 4.55 kg/m², p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

• 한국임상수의학회지
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• 제27권1호
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• pp.107-112
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• 2010

A 3-years-old female Pointer was evaluated for anorexia, dyspnea and exercise intolerance for 10 days. Auscultation revealed muffling of heart sound. There were leukocytosis, anemia, hypoalbuminaemia and hyperglobulinaemia on the blood profiles. Radiography showed severe pleural effusion. Thorax ultrasonographs described traped pleural effusion, pericardial effusion and collapsed right lung lobe(s). On CT images, thoracic neoplasia and lung torsion were ruled-out. Thoracocentesis with thoracoscopy and bacterial culture revealed pyothorax and pleuritis. The diagnosis of pyothorax in dogs and cats is based on clinical signs, radiography, thoracocentesis and cytology and culture of the exudate. In this case, various diagnostic medical imaging techniques (radiography, ultrasonography, CT and thoracoscopy) were used for diagnosis of pyothorax.

• Journal of Chest Surgery
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• 제19권4호
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• pp.695-698
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• 1986

Only five instances of chylopericardium following cardiac surgery have been reported in the literature previously. We encounted this complication in a patient who was operated on for secundum atrial septal defect. The patient readmitted one month after discharge because of large amount of chylous pericardial effusion. Conservative treatment of pericardiostomy drainage and parenteral hyperalimentation was continued for 3 weeks without improvement. Partial pericardiectomy and pericardiopleural window was done with success and no recurrence of chylopericardium was observed upto 3 months after surgery. We think this is the first case report of chylopericardium after open heart surgery in Korea.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1131-1134
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• 1999

After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

• Tuberculosis and Respiratory Diseases
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• 제59권3호
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• pp.321-325
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• 2005

저자들은 복수나 심낭액, 심부전의 소견 없이 갑상선기능저하증에 의해 발생한 일측성 흉막액을 진단하고, levothyroxine sodium 치료로 호전을 보인 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.