• The Journal of the Society of Stroke on Korean Medicine
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• v.6 no.1
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• pp.63-68
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• 2005

Objective: The purpose of this case study is to show a case of early neurological recovery from stroke by recannalization. Methods: The patient was admitted from 12 July, 2004 to 26 July, 2004. The patient received Herb-Medication and Acupuncture Therapy. Brain MRI and Tc-99m HM-PAO brain SPECT was used to diagnose and prognose. Results: The patient fully recovered within a few hours. She was diagnosed as acute infarction in Lt. BG by using brain MRI. Tc-99m HM-PAO brain SPECT showed focal increased perfusion at Lt. BG. Conclusions: We suggest that the important thing to recovery from stroke is recannalization of cerebral arteries in early stage.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.989-993
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• 1995

Patent ductus arteriosus in adult is frequently complicated with aneurysm, calcification and pulmonary hypertension. Therefore, surgical treatment of patent ductus arteriosus in adult has some differences from that of infants and children. We have experienced 25 cases of adult patent ductus arteriosus from July 1983 to December 1994. Mean age of the patients was 26.6 years[16-59 years . There were 12 males and 13 females. Exertional dyspnea was the most frequent clinical manifestation. Pulmonary hypertension was present in eight patients. Ligation was done in 20 cases and surgery using cardiopulmonary bypass was done in 5 cases. There was one hospital death, which had a 5x5cm sized main pulmonary artery aneurysm and was operated under cardiopulmonary bypass. Recanalization occured in one patient who received Teflon-felt supported ligation. Although one case of recannalization after ligation was present, we believed the fact that ligation was safe and simple method of operation in adult patent ductus arteriosus without calcification and aneurysm.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1157-1160
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• 1992

Aortic valve repair with the use of tailored autologous pericardial extension to the native cusp was performed in one patient with rheumatic aortic valve incompetence. The patient was a 10-year-old girl with Grade II aortic regurgitation and tiny postoperative recannalization of the patent ductus arteriosus. The left aortic coronary cusp appeared to be a little thickened and a cicatrical shortening of the distance between the free edge of the cusp and its annular attachment. A semilunar shaped patch of autologous pericardium, treated with glutaraldehyde solution[6 minutes in 0.6% solution] was sutured along the free edge of the left coronry cusp. Postoperative recovery was uneventful. Echocardiography 8 months later showed Grade I aortic regurgitation. She is now conducting as usual life.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.775-780
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• 1989

This study concerns the late results observed at follow-up[average: 32.5 months] of 23 patients, in whom Patent Ductus Arteriosus with pulmonary hypertension among 55 patients. They were operated from May 1984 to July 1987 in Chonnam University Medical School. There was predominance of woman [2.5:1]. No operative death occurred. All of patients subside preoperative symptoms, but 1 patient diagnosed recannalization of duct at follow-up. Systolic murmur was found over the pulmonary area in 5 patients [22 %], but it may be not related to systolic pulmonary arterial pressure[SPAP]. Also, SPAP were normalized in 74 % of patients and had mild hypertension in 26 % of patients. Although the patients had Patent Ductus Arteriosus with pulmonary hypertension, successful surgical correction was carried out safely in all instance but one, by ligation and facilitated by hypotensive anesthesia.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.996-1002
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• 1988

A clinical analysis was performed on 115 cases of -patent ductus arteriosus treated surgically during the period of 11 years from Aug. 1977 to Jul. 1988. at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. Among 115 cases, male was 38 and female was 77 and ages ranged 12 days to 27 years old with the average of 8 7/12 years. The major clinical symptoms on admission were frequent URI attack[77.4%], dyspnea on exertion[32.2%] and palpitation[13%]. On auscultation, continuous machinery murmurs were detected in 97 cases[84.3%] and loud systolic murmurs were detected in 18 cases[15.7%]. Preoperative electrocardiographic findings were as follows: LVH 59[51.3%], RVH 12[10.4%], BVH 16[13.9%] and WNL 28[24.3%]. Radiologically, there were increased pulmonary vascularity in 104[90.4%] and cardiomegaly 62[53.9%]. Cardiac catheterization were performed in 101 cases and mean systolic pulmonary arterial pressure was 49.84*29.7mmHg and mean Qp/Qs was 2.95k1.8. Methods of operation were multiple ligation in 96, division in 11 and transpulmonary arterial repair using cardiopulmonary bypass in 8. Complication were recannalization in 2, temporary hoarseness due to left recurrent laryngeal nerve paralysis in 3 and respiratory distress in 1 and overall mortality rate was 1.7%[2 cases].

• Journal of Chest Surgery
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• v.24 no.9
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• pp.853-860
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• 1991

A clinical study on 139 cases of operated PDA was performed during period from Aug. 1982 to Apr. 1991 at the Dept. of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital. The following results are obtained. 1. The 35 males and 104 females ranged in age from 6 months to 40 years. [mean 10.2 yrs. ] 2. Chief complaints of the patients were frequent URI in 50%, dyspnea on exertion in 31.2%, palpitation in 11.1%, and no subjective symptoms in 28.78% 3. On auscultation, continuous machinery murmur heard in 79.86% and systolic murmur in 20.14%. 4. Radiologic findings of chest P-A showed increased density of pulmonary vascularity in 80.58%, cardiomegaly in 61.87%, and within normal limit in 19.42% of the patients. 5. The signs of LVH[44.4%], RVH[17.4%], BVH[7.6%] were noted on the EKC. 6. Cardiac catheterizations were performed in 114 patients. The mean Qp/Qs was 2.65 and the mean Pp /Ps was 0.41 and the mean systolic pulmonary artery pressure was 46.6 mmHg. 7. Operative methods were as followed: The 130 cases[93.52%] of ligation and 3 cases[2.16%] of division & suture for PDA were performed through the left posterolateral thoracotomy. And the remained cases were managed under the cardiopulmonary bypass. 8. Operative complications were hoarseness in 8 cases, atelectasis in 6 cases, intraoperative ductal rupture under the left thoracotomy approach 2 cases, recannalization 1 case and others in 3 cases. 9. One patient died due to ductal rupture intraoperatively and the overall mortality was 0.7%.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.165-173
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• 1985

A clinical analysis was performed n 706 uses of patent ductus arteriosus experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 27 years period from 1958 to 1984. Of the 706 patients of PDA, 244 patients were male and 462 patients were female and ages ranged from 2 months to 53 years old with the average age of 8.5 years. The chief complaints on admission were dyspnea on exertion and frequent URI in 58.9%, non specific symptoms such as palpitation and easy fatigability in 9.7%, symptoms of CHF in 2.0% and no subjective symptoms in 29.4%. On auscultation of heart, continuous machinery murmurs were heard in 82% and only systolic murmurs were heard in 18% of patients. On simple chest PA of patients, cardiomegalies were detected in 78% and there were increased pulmonary vascularities in 93% of patients. EKG findings were as followed; LVH 56.9%, BVH 12.6%, RVH 2.9% and WNL 27.6%. Cardiac Catheterizations were performed in 512 patients and mean Qp/Qs was 2.56 and mean systolic pulmonary artery pressure was 45mmHg. Operation methods were as followed; in patients in whom operations were performed on PDA only, ligation 94.3%, division 3.7% and ligation [0.5%] or trans-pulmonary artery suture closure [1.5%] under cardiopulmonary bypass 2.0% and in patients in whom operations were performed with associated anomalies, ligation 17.6%, division 2.4%, and ligation [44.7%] or trans-pulmonary artery suture closure [35.3%] under cardiopulmonary bypass 80%. 52 postoperative complications [8.4%] were developed in 42 patients [6.8%] and its were as followed; permanent or transient hoarseness 16 [2.6%], intraoperative rupture of PDA 8 [1.3%], recannalization 6 [1.[%], operative death 5 [0.8%], late death 4 [0.6%] and other miscellaneous complications 13 [2.1%]. 140 associated cardiac anomalies [19.8%] were found in 105 patients [14.9%] and its were as followed; VSD 68 [9.6%], COA 15 [2.1%], Subaortic discrete membrane 7 [0.9%], ASD 6 [0.8%], TOF 5 [0.7%] and other miscellaneous and

• Journal of Chest Surgery
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• v.28 no.2
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• pp.136-142
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• 1995

A clinical study was performed on 69 cases of isolated PDA surgically treated at the Department of Thoracic and Cardiovascular surgery of Kyung-Hee University Hospital from Mar. 1986 to Feb. 1994. Retrospective clinical analysis of these patients were as follows: 1.23 males and 46 females ranged in age from 16 days to 49 years. [mean 8.69yrs.,sex ratio M:F=1:2 2. Chief complaints were frequent URI in 44%, dyspnea on exertion in 16%,palpitation in 8%, easy fatigability in 6%, and no subjective symptoms in 26%. 3. On auscultation, typical continuous machinery murmur heard in 84%, and systolic murmur in 16% on Lt 2nd or 3rd intercostal space. 4. Simple chest x- ray showed increased pulmonary vascularity in 67%, cardiomegaly in 61%,and within normal limit in 16%. 5. EKG findings were LVH in 42%, biventricular hypertrophy in 17%, RVH in 3%, and within normal limit in 38%. 6. Echocardiogram was performed from all patient, and direct visualization of ductus in 93% 7. Cardiac catheterization was performed in 39 patients. The mean value of the results were;Differance SaO2[MPA-RV =11.03$\pm$ 5.26%,Qp/Qs=2.44$\pm$1.35,systolic pulmonary arterial pressure=40.69 $\pm$ 17.69mmHg. 8. 66 patients were operated through the left posterolateral thoracoctomy ; closure of ductus by double ligation in 43 cases, triple ligation in 23 cases.3 patients were operated by simple closure under cardiopulmonary bypass. 9. There was no death associated with the operation. The operative complications were atelectasis in 8 cases, pneumonia in 4 cases recannalization in 2 cases, and hoarseness in one case. 10. Systemic diastolic pressure was increased 8.12$\pm$ 0.13mmHg, and pulse pressure was decreased about 9.52 $\pm$ 1.87mmHg.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.590-599
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• 1996

Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.