• Title/Summary/Keyword: Pulmonary Vein

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Surgical Results and Risk Facor Analysis of the Patients with Single Ventricle Associated with Total Anomalous Pulmonary Venous Connection (총폐정맥연결이상증을 동반한 단심증 환아의 수술결과 및 위험인자 분석)

  • 이정렬;김창영;김홍관;이정상;김용진;노준량
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.862-870
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    • 2002
  • The surgical results of the patients with single ventricle(SV) associated with total anomalous pulmonary venous connection(TAPVC) has been reported with high mortality and morbidity due to their morphologic and hemodynamic complexity. A retrospective review was undertaken to report the outcome of the first-stage palliative surgery in our institution and to determine the factors influencing early death. Material and Method: Between January 1987 and June 2002, 39 patients with SV and TAPVC underwent surgical intervention with or without TAPVC repair. Age at operation ranged from 1day to 10.7months (median age, 2.4month), and 29 patients were male. Preoperative diagnosis included 20 right-dominant SV, 15 SV with endocardial cushion defect, 3 left-dominant SV, and 1 tricuspid atresia. The pulmonary venous connection was supracardiac in 22, cardiac in 5, infracardiac in 11, and mixed in 1, Obstructed TAPVC was present in 11. First-stage palliative surgery was performed in 37. Repair of TAPVC, either alone or in association with other procedures, was performed during the initial operation in 31. Univariate and multivariate analyses were performed to analyze the risk factors influencing the operative death. Result: A mean follow-up period of survivors was 34.3 $\pm$ 43.0(0.53 ~ 146.2)months. Overall early operative mortality was 43.6%(17/39). The causes were low cardiac output in 8, failure of weaning from cardiopulmonary bypass in 3, sepsis in 2, pulmonary hypertensive crisis in 1, pulmonary edema in 1, pneumonia in 1, and postoperative arrhythmia in 1. Risk factors influencing early death in univariate analysis were body weight, surgical intervention in neonate, obstructive TAPVC, preoperative conditions including metabolic acidosis, and need for inotropic support, TAPVC repair in initial operation, operative time, and cardiopulmonary bypass(CPB) time. In multivariable analysis, body weight, age at initial operation, surgical intervention in neonate, preoperative conditions including metabolic acidosis, need for inotropic support and CPB time were the risk factors. Conclusion: In this study, we demonstrated that the patients with SV and TAPVC had high perioperative mortality. Preoperative poor condition, young age, the length of operative and CPB time, the presence of obstructive TAPVC had been proven to be the risk factors. This fact suggests that the avoidance of unnecessarily additional procedures may improve the surgical outcomes of the first-stage palliative surgery. However further observation and collection of the data is mandatory to determine the ideal surgical strategy.

Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

  • Lee, Sub;Kim, Han-Woong;Kang, Hyoung-Seok;Bae, Chi-Hoon;Jheon, Sang-Hoon;Kwon, Oh-Choon;Ahn, Wook-Su
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.672-679
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    • 2001
  • Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

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Is routine screening examination necessary for detecting thromboembolism in childhood nephrotic syndrome? (소아 신증후군 환자에서 혈전증 검색을 위해screening 검사가 필요한가?)

  • Kim, Mun Sub;Koo, Ja Wook;Kim, Soung Hee
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.736-741
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    • 2008
  • Purpose : The incidence of thromboembolic episodes in children with nephrotic syndrome (NS) is low; however, these episodes are often severe. Moreover, both pulmonary thromboembolism (PTE) and renal vein thrombosis (RVT) rarely show clinical symptoms. This study was performed to determine the benefits of routine screening in the detection of thrombosis in childhood NS. Methods : Among 62 children with nephrotic syndrome, a total of 54 children (43 males, 11 females) were included in this study. When the patients experienced their first NS episode, we performed renal Doppler ultrasonography in order to detect RVT. To rule out the possibility of PTE, a lung perfusion scan was performed. Computed tomographic (CT) pulmonary angiography was recommended to patients who showed possible signs of PTE. All patients were evaluated for clinical signs of thrombosis, biochemical indicators of renal disease, as well as clotting and thrombotic parameters. Results : RVT or related clinical symptoms were not observed in any children. Based on the findings of the lung perfusion scans, 15 patients (27.8%) were observed with as a high probability of PTE. We were able to perform a CT pulmonary angiography only on 12 patients, and 5 patients were diagnosed with PTE (prevalence 8.1%). The serum fibrinogen level in the group with PTE was significantly higher ($776.7{\pm}382.4mg/dL$, P<0.05) than that in the group without PTE, and other parameters were not significantly different between each group. Conclusion : Further studies are required for clarifying the role of renal Doppler ultrasonography for the detection of RVT in NS. Children with NS who developed non-specific respiratory symptoms should be evaluated for the diagnosis of PTE. In the management of NS, a lung perfusion scan should be performed at the time of the initial episode of NS regardless of the pulmonary symptoms, since patients having PTE are either often asymptomatic, or present with nonspecific symptoms.

The Current Research Methodology of Pharmacopucture for the Treatment of Animal Cancer Models in Korea (암에 대한 약침치료의 국내 동물모델 연구 현황)

  • Ryu, Hee Kyoung;Goo, Bon Hyuk;Suk, Kyung Hwan;Lee, Ju Hyeon;Ryu, Soo Hyeong;Lee, Su Yeon;Kim, Min Jeong;Park, Yeon Cheol;Baek, Yong Hyeon;Park, Dong Suk;Seo, Byung Kwan
    • Journal of Acupuncture Research
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    • v.31 no.4
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    • pp.81-97
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    • 2014
  • Objectives : The purpose of this study is analyzing the current research methodology of pharmacopucture for the treatment of animal cancer models. Methods : Four electronic databases were searched for animal studies published from January 2000 to September 2014 onward using these search terms "cancer, anticancer, pharmacopuncture, beevenom". Selected articles were described about animal cancer models. The methods used to induce cancer and the outcome measures used to assess the effects of pharmacopuncture on animal cancer models were analyzed. Results : 37 articles were included. For producing animal cancer models BALB/C mice(n=22) and C57BL/6 mice(n=17) were selected. And intravenous injection of B16-F10 melanoma cells into tail vein(n=14) or intraperitoneal injection of sarcoma-180 cells(n=14) were frequently used to induce cancer. Various pharmacopunctures were injected into acupoints $CV_{12}(n=19)$, $ST_{36}(n=8)$, $BL_{18}(n=8)$ or peritoneal cavity(n=6), tumor site(n=2), tail vein(n=2). Outcome measures were categorized into anti-cancer, anti-metastasis, general condition, cytotoxicity, immune response, toxicity. Median Survival Time(MST) and increase of life span(ILS)(n=26) was frequently used for evaluating anti-cancer effects. And pulmonary colonization assay(n=13) was frequently used for evaluating anti-metastasis effects Conclusions : Based on these data, further research would be needed to ascertain the effectiveness of pharmacopuncture for treating cancer and broaden the range of clinical applications.

A Survey on Diseases and Symptoms of the nurses who were Employed at the City and University hospitals in Seoul (서울시내 종합병원에 근무하는 간호원들의 질병 및 증상에 관한 조사)

  • 김매자;이선자;박순자
    • Journal of Korean Academy of Nursing
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    • v.5 no.1
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    • pp.70-78
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    • 1975
  • The investigators conducted this survey to find out prevalence of diseases and symptoms of the 812 nurses who were working at the 12 Seoul city and University's hospital in Seoul by retrospective study The results of survey were summarized as follows: 1. Distribution of Prevalence Rate of Diseases and Symptoms. 1) An average prevalence rate of diseases and Symptoms of the nurses/100 persons was 64.3 cases at Present October I.1972 2) The total number of diseases and Symptoms was 522 cases at present Oct, I 1972 for the survey nurses. The prevalence rate of following diseases/100 persons were as, foot sore-11, 3. myopia-9.7, neuralgia-9.6, anemia-9.1, insomnia-8.6 cases and the corrected number percent of prevalence rate of diseases and symptoms of the above diseases into 100 denominator were as follows : foot sore-17.6% , myopia-15.4%, neuralgia-14.9%, anemia-14.2% insomnia-13.2%. 3) The prevalence rate of diseases and symptoms/100 person for the age group of 45 and over was 140.0 cases and the age of 35-39 years was 27.3 cases. 4) The prevalence rate of diseases and symptoms/100 persons by the rotation system of nurses'duty/day were as follows: two shift system rotation-86.7 cases, three shift system rotation-67.9 cases and day duty only was 56.2 cases, 5) The prevalence rate of diseases and symptoms/100 person by the basic nursing education background seemed to be lower occurrence against to the higher education and it was 94.4 cases at the Technical Nursing High School graduates. 6) The prevalence rate of diseases and symptoms/100 persons by the marital status of the nurses were as follows; single-64.8 cases, married-48, 7 cases, and widowed-28.6 cases. II. Relationship Between working Experience and prevalence of the Disease and symptoms. 1) There were no relationship by statistical test between prevalence of eye disease and experience at the eye ward(p〉0.05), skin disease and experience at the dermatology ward (p〉0.05), foot sore and experience at the operating room (p〉0.05), varicose vein and experience at the operating room (p〉0.05), sore finger and experience at the central supply room (p〉0.05), infectious disease and experience at the isolation ward(p〉0.05). 2) There was significant relationship by statistical test between pulmonary tuberculosis and experience at the tuberculosis ward (p〉0.05) prevalence of pulmonary tuberculosis was five times in experienced group than non experienced group.

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Primary Left Atrial Myxofibrosarcoma -A case report- (좌심방에 발생한 악성 원발성 점액섬유성육종 -1예 보고-)

  • Yoon, Yoo-Sang;Lee, Cheol-Joo;Kang, Joon-Kyu;Kim, Hyung-Tai;Choi, Ho;Lee, Kyi-Beom
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.422-426
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    • 2003
  • Primary cardiac tumor has very low incidence, especially in cases of malignancy. A 29 year old male patient visited our cardiologic clinic for recent aggrevation of dyspnea on exertion and palpitation. Echocardiography showed a large tumor in the left atrium, which suggested the left atrial myxoma. Urgent open heart surgery was taken. The operative finding was fossa ovalis based a large tumor (35$\times$90$\times$50 mm) that invaded the posterior wall of LA and right superior pulmonary vein directly. The tumor was excised well by simple dissection, and the final pathologic report was malignant myxofibrosarcoma. His postoperative course was smooth and he was discharged in good health. Postoperative radiation and chemotherapy had taken with satisfactory clinical outcome.

Study on the Anti-cancer, Anti-metastasis and Effects of Immune-response of Aqua-acupuncture with Cuscutae Semen Infusion Solution (토사자약침(兎絲子藥鍼)의 항암작용(抗癌作用) 및 면역효과(免疫效果)에 대(對)한 실험적(實驗的) 연구(硏究))

  • Lee, Jae-Bok;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.18 no.3
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    • pp.94-104
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    • 2001
  • Objective : The objective of tihs study is to study the effects of anti-cancer, anti-metastasis and effects of immune-response of aqua-acupuncture with Cuscutae Semen infusion solution. Methods : We observed, in-vitro, the cytotoxicity and the effect on the expression of MMP-9 gene, and in-vivo, change of body weight, surviving number, MST, ILS, changes in amount of WBC, RBC, PLT, GOT, GPT, creatinine, glucose and LDH, number of Pulmonary colony. Results : 1. The effect on expression of MMP-9 gene was decreased in all the sample groups in B16-F10 cell line, and was decreased in Lane 1, 2, 3 in HT1080 cell, compared with control group. 2. BALB/c mice which was transpianted S-180 cancer cell line were inhibited significantly in weight increase, in all the sample groups, compared with control group. 3. The sample groups injected in vein with B16-F10 cancer cell line in C57BL/6 mice did'nt show significant change in the number of WBC, RBC, PLT. 4. In immune experiment, all the sample groups showed having more relevancy to the effect on splenic cell proliferation than normal groups. 5. $IFN-{\gamma}$ and $TNF-{\alpha}$ in cytokine-gene were increased in all the sample groups than control group. 6. In flow cytometry of spienic cell, the numbers of CD4+ cell, CD8+ cell and CD19+ cell in sample groups were increased than in control group. Conclusion : Above the results showed that aqua-acupuncture of Cuscutae Semen infusion solution has effects of anti-cancer, anti-metastasis and immune response improvement.

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Emodin from Polygonum cuspidatum showed Angiogenesis Inhibiting Activity in vitro (호장근으로부터 분리된 emodin의 혈관신생 억제 활성)

  • Lee, Tae-Kyoo;Kim, Jong-Hwa;So, June-No
    • Applied Biological Chemistry
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    • v.46 no.1
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    • pp.50-54
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    • 2003
  • Polygonum cuspidatum has been used as a fork medicine for a long time. Emodin was purified from the root of P. cuspidatum by thin layer chromatography (TLC) and preparative high perfomance liquid chromatography (HPLC). The effects of emodin on the migration of endothelial cells and in vitro angiogenesis stimulated with vascular endothelial cell growth factor (VEGF) were examined, using human umbilical vein endothelial cells (HUVECs) and porcine pulmonary arterial endothelial cells (PPAECs). Emodin potently inhibited the VEGF-induced migration of (HUVECs) at relatively low cocentrations $(0.1-10\;{\mu}g/ml)$; the inhibition of endothelial cells by emodin was 75.4% at $0.1\;{\mu}g/ml$ and about 90% at $1\;{\mu}g/ml$. Emodin also inhibited VEGF-induced sprout formation in vitro at concentrations of $0.1-10\;{\mu}g/ml$. Emodin was also evaluated for the inhibitory potential on in vivo angiogenesis in a growing chick embryo chorioallantoic membranes (CAM). At a concentration of $1.0\;{\mu}g/ml$ Per disc, emodin was able to induce avacular zone in the CAMs. These findings suggest that emodin is a potent angiogenesis inhibitor and P. cuspidatum is a useful herb in the development of therapeutics for angiogenesis dependent diseases.

Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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Left Atrial Rupture with Stable Vital Signs - A case report - (정상인 활력증후를 보인 좌심방 파열 - 1예 보고 -)

  • Jeong, Jae-Han;Cho, Sung-Woo;Shin, Yoon-Cheol;Lee, Hee-Sung;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.633-635
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    • 2008
  • Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.