• The Korean Journal of Pharmacology
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• v.11 no.1 s.17
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• pp.7-13
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• 1975

In Chinese medicine, it is said that Aconiti tuber has cardiotonic, diuretic and analgesic effects. Kim et al reported that alkaloid free part of Aconiti tuber, $CHCI_3$ insoluble fraction, showed inotropic effect on isolated frog heart and inotropic effect is potenciated by n-butanol fractionation. To investigate the effect of Aconiti tuber butanol fraction on the mechanical and electrical properties of heart, change of active tension, excitability and refractory period of isolated rabbit atrium in the presence of butanol fraction were measured and the comparison with that of ouabain and quinidine was done. The observed results are as follows. 1. $5{\times}10^{-4}g/ml$ concentration of Aconiti tuber butanol fraction showed approximately same effect with therapeutic concentration of ouabain on the increment of contractile force, and the effect of $2{\times}10^{-3}g/ml$ was greater than that of $1{\times}10^{-5}g/ml$ of ouabain. 2. Acceleration of rate of contractile force increment in the presence of Aconiti tuber butanol fraction was greater than in ouabain, and the time to maximum tension was shorter in Aconiti tuber butanol fraction than in ouabain. 3. The excitability of isolated atrium was slightly increased at low concentration of Aconiti tuber butanol fraction, while decreased at higher concentration. 4. Aconiti tuber butanol fraction slightly prolonged refractory period of isolated right atrium at the concentration of $2{\times}10^{-3}g/ml$.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.60-65
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• 1980

We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.33-42
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• 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
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• v.29 no.3
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• pp.311-314
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• 1996

Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.67-72
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• 2010

Ten percent of all myxomas are the familial form. Familial myxomas appear to have autosomal dominant transmission. We experienced two siblings with familial myxomas. A left atrial myxoma was surgically removed in a 21-year-old woman. Six years later, other myxomas were found in the right atrium and the left atrium and these were also surgically removed. Right ventricular and right atrial myxomas were surgically excised in her brother. The two siblings were found to have frame-shift mutations in the PRKAR1A gene (c.537delA; p.Gly180GlufsX26), which is the causative gene for Carney complex. Obtaining the genetic diagnosis makes it possible to prepare more effective therapeutic strategies for these patients and the gene carriers. Complete excision, ruling out multicentricity and proper postoperative follow up are all necessary to avoid recurrence of myxoma.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.158-161
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• 1990

A congenital coronary artery fistula is an uncommon anomaly which has a direct communication between a coronary artery and the lumen of any one of the four cardiac chambers, or the coronary sinus, or its tributary veins or the superior vena cava. The right coronary artery is involved most frequently, and the abnormal communication in most often is to the right ventricle followed in incidence by drainage into the right atrium and the pulmonary artery. Recently. we experienced a case of congenital coronary artery fistula associated with valvular heart disease. The fistulous communication was noted between the left circumflex artery and the left atrial appendage. Under the cardiopulmonary bypass, the internal obliteration of the left atrial appendage, mitral valve replacement, and aortic valve exploration were accomplished. Postoperative hospital course was uneventful and the patient was discharged without any problems.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.189-194
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• 1973

A cardiac injury is one of the most dramatic and demanding emergencies than may be cared by the surgeon. Four patients who sustained penetrating wound of the heart have been experienced in the Depart-ment of Thoracic Surgery, Kyungpook National University Hospital. They were 3 males and one female. The age was between 21 and 25. All of this series had stab wounds on the heart by instruments of scissors, gimlet, kitchen knife and glass. Injured sites were two cases of right ventricle, one of the right atrium and one of indifinitive with pericardial laceration. Three of these patients have been successfully treated by emergency thoracotomy with 3-0 silk sutures for myocardial penetrating wounds. One of these patients occurred cardiac arrest during surgery and expired, who was in penetrated right ventricular injury through which massive bleeded. The classic clinical description of tamponade, Beck`s triad, seemed to be useful for making diagnosis of the tamponade but not entirely reliable as diagnostic criterion of the tamponade. In the studing of 3 tamponade cases in these series, the triad of Beck was presented in only two cases. Elevated venous pressure was thought to be a valuable diagnostic factor in pericardial tamponade.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.391-397
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• 1985

Ebstein`s anomaly is a rare congenital cardiac malformation and characterized by downward displacement of an abnormal tricuspid valve cusps. But until now, the ideal surgical correction is still controversial. We present a case of Ebstein`s anomaly experienced lately. The patient was 13 year old girl with the complaints of dyspnea on exertion, fatigability and cyanosis. Echocardiography revealed downward displacement of septal leaflet of tricuspid valve and atrialized right ventricle. Cardiac catheterization and cineangiography revealed ASD and large right atrium. During operation, the atrialized right ventricle was plicated and tricuspid annuloplasty was done. And the two secundum type ASD`s were closed by direct suture closure. The patient`s postoperative course was uneventful and discharged on the 24th postoperative days.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.715-722
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• 1984

From 1978 to April 30 84 thirteen cases of cardiac injured patients were operated under general anesthesia at Department of Thoracic and Cardiovascular Surgery in Chonnam National University. These patients were divided Into two groups according to their cause of trauma: Group 1, penetrating cardiac injury and Group II, blunt cardiac injury. 1.In 7 cases of Group 1, 6 cases were stab wound and one case was gunshot wound, and among 6 cases of Group II, 3 cases traffic accident, 2 cases pedestrian, 1 case agrimotor accident. 2.The sites of cardiac injury in penetrating trauma were right ventricle mainly and the next left ventricle and in blunt trauma right ventricle, myocardial contusion, right atrium, and inferior vena cava in order. 3.In most of cases central venous pressure was elevated above 15 cmH2O and in 5 of 13 cases revealed cardiomegaly in simple chest X-ray. 4.The relationship between the condition on arrival and the time to operation is not significant. 5.Associated injuries in penetrating cardiac trauma were hemothorax, pneumothorax, laceration of lung and in blunt trauma hemothorax, sternal fracture, rib fracture and pneumothorax in order. 6.One case of gunshot injury died after operation.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.373-377
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• 1978

Aneurysmal rupture of sinus Valsalva is known as one of rare cardiac disease and not controlled with medical treatment. We experienced 9 cases which were composed with 7 case of male and 2 cases of female during last 15 years. 7 cases were ruptured into right ventricle from right. coronary sinus and 2 cases were ruptured into right atrium from non-coronary sinus. The diagnosis was made with cardiac catheteriza1icn and cineangiccardicgram but 2 cases were misdiagnosed with only cardiac catheterization. All cases were corrected under cardiopulmonary bypass with means of direct suture with tdlon pledget by transatrial or transventricular approach. All were not confirmed in it's origin because of no history, no evidences of syphilis, TB, or bacterial endocarditis and only fibrosis in pathologic report. In postoperative course, 1 case had postoperative bleeding and 1 case was sufferd from left hemiplegia due to may be air embolism. Follow up study revealed all patient go on their usual life well with good improvement at this present time.