• 한국임상수의학회지
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• 제21권3호
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• pp.314-318
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• 2004

A 7-month-old 8.2 kg female Siberian Husky with history of exercise intolerance, delayed growth, and tachypnea was presented to Veterinary Medical Teaching Hospital, Kyungpook National University. A holosystolic murmur was identified in cardiac ausculation. In electrocardiography, thoracic radiographs, and ultrasonography, a right axis deviation, enlarged right ventricle, stenotic main pulmonary artery, large ventricular septal defect, marked right ventricle hypertrophy, and overriding aorta with dilation were identified. The color Doppler examination showed the left-to-right shunting of blood via interventricular septal defect and the blood flow streams converging from the right and left ventricles into the aorta. The dog was diagnosed as tetralogy of Fallot. The current state of the dog is well-tolerated without any specific medication.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.462-467
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• 2008

Kawasaki disease is a systemic vasculitis of unknown etiology, usually occurring in infants and young children. Although the etiology of Kawasaki disease remains uncertain, its serious complicationssuch as giant aneurysm formation, coronary arterial stenotic lesions, and thrombotic occlusionhave been proven to cause myocardial ischemia or infarction in patients with Kawasaki disease. To prevent and treat these complications, several modes of therapyincluding long-term anticoagulation, interventional catheterization, and surgical treatmenthave been gradually developed. In this article, we review the cardiovascular complications following Kawasaki disease and the management thereof, which includes thrombolytic therapy, catheter intervention, and coronary artery bypass graft.

• 대한수의학회지
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• 제47권1호
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• pp.99-102
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• 2007

A 3-year-old, intact female, Shih-tzu dog was presented with a 15-day history of vomiting,depression, and anorexia. On physical examination, systolic ejection murmurs with precordial thril atthe left heart base were detected. A diagnosis of congenital pulmonic stenosis (PS) was made mainlyfrom the thoracic radiography, electrocardiography, and echocardiography. On complete blood counts andconfirmed that main pulmonary artery was tremendously buldged and electrocardiography was suggestiveof severe right ventricular hypertrophy. Echocardiographic findings revealed the pulmonic valve stenosiscontaining valvular dysplasia and poststenotic dilation. On Doppler echocardiography, ejection velocityof the lesion accounted for 3.38 m/sec, meaning mild velocity through the stenotic area. The dog'sproblem and resulted in death. However, there has been no reliable relation between PS and CRF. Primarymalformation of pulmonic valve was confirmed at necropsy after death.

• 대한핵의학회지
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• 제24권2호
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• pp.325-331
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• 1990

Radionuclide renal scintigraphies were performed in a 24-year-old man with right renal artery branch stenosis. Captopril enhanced $^{99m}Tc-DTPA$ renal scintigraphy revealed no abnormal finding in the right kidney. But, $^{99m}Tc-DMSA$ renal scintigraphy showed regional cortical photon deficient area corresponding to the area supplied by the stenotic branch artery. The defect size increased in captopril enhanced $^{99m}Tc-DMSA$ renal scintigrphy and nearly disappeared after successful transluminal renal angioplasty. This case suggests that the captopril enhanced $^{99m}Tc-DMSA$ renal scintigraphy may be a useful method in the evaluation of renovascular hypertension, especially due to branch renal srtery stenosis.

• Journal of Chest Surgery
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• 제38권9호
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• pp.633-636
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• 2005

출생 직후 Carpentier-Edward D형의 Ebstein 기형을 진단 받은 신생아가 심한 저산소증 및 심부전의 증상을 보여 생후 16일째 응급수술을 시행하였다. 수술 소견 상 거대한 우심방 및 심방화 우심실, 작은 기증적 우심실, 삼천 판막의 중격엽 및 후엽의 심한 하향 전위 및 전엽의 우심실 전벽 유착 등이 관찰되었고, 전형적인 협착성 엡스타인 기형으로 양심실 교정이 북가능한 상태로 판단되어 변형 starnes 술식을 적용하였다. 즉 폐동맥판막 및 전위된 삼첨판막 개구창을 일차 봉합 폐쇠하고 광범위한 심방 중격 절제술 등을 시행한후 우심실 전벽과 심실 중격 사이를 우심 첨부에서부터 다중 봉합하여 막성 중격 주변으로 10mm 정도 남기고 심방화 우심실 내부를 모두 봉합 폐쇄하였다. 또한 폐혈류 유지를 위하여 4mm ringed Gore-Tex 도관을 무명동맥에서 주폐동맥까지 연결하였다. 환자는 수술 후 경과가 양호하여 술 후 17일째에 퇴원하였으며, 6개월 후 큰 문제없이 양방향성 상대정맥-폐도맥 단락술을 시행할 수 있었다. 저자 등은 심한 협착성 엡스타인 기형 환자에게 간편하면서도 안전하게 심방화 우심실을 혈역학으로부터 제외시키는 변형 Starnes 방법을 적용하여 좋은 성적을 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제24권3호
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• pp.310-321
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• 1991

Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.

• Journal of Chest Surgery
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• 제5권1호
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권2호
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• pp.278-283
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• 2004

저자들은 이전에 건강했던 여아에서 갑작스런 복통과 담즙성 구토 증세를 보여 단순 복부 방사선 소견에서 소장 폐쇄 소견과 소장 조영술을 시행하여 협착 부위를 확인하고 수술을 시행 후 게실 간막 띠에 의한 소장의 폐쇄를 관찰한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2001년도 춘계학술대회논문집E
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• pp.219-222
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• 2001

The objective of the present study is to evaluate the effects of the stenting shapes on flow velocity and wall shear stress in angulated coronary stenosis by computer simulation. Coronary angiogram and Doppler ultrasound measurement in the patients with angulated coronary stenosis were obtained. Inlet wave velocity distribution obtained from in vivo intracoronary Doppler data was used for the numerical simulation. Spatial pattern of blood flow velocity and recirculation area were drawn through out the selected segment of coronary models. Wall shear stresses in the intracoronary stent models were calculated from three-dimensional computer simulation. A negative shear stress region, which is consistent with re-circulation area on flow pattern, was noted on the inner wall of post-stenotic area of pre-stenting model. The negative shear stress was disappeared after stenting. Shear stress in the post-stenting model was markedly reduced up to about two orders of magnitude compared to that of the pre-stenting model.

• Journal of Korean Neurosurgical Society
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• 제42권6호
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• pp.427-435
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• 2007

Recently, intracranial atherosclerosis has become a major cause of ischemic stroke, appearing more frequently in Koreans than Caucasians. Symptomatic or asymptomatic intracranial atherosclerosis is a disease that could recur readily even during the treatment with anti-platelet agents. When the symptoms develop, ischemic stroke can not be recovered readily. Therefore, aggressive treatments such as endovascular therapy and bypass surgery are required in addition to medical treatment for the intracranial artery stenosis. Recent intracranial stenting and drug eluting stenting have shown as very advanced effective therapeutic modalities. Nevertheless, until now, a randomized controlled study has not been conducted. Regarding bypass surgery, since the failed EC-IC bypass surgery study performed 20 years ago, extensive studies on its efficacy has not been conducted yet, and thus it has to be performed strictly only in hemodynamically compromised patients. Unless breakthrough drugs that suppress the progression of intracranial atherosclerosis and the formation of thrombi, and facilitate the regression of the arterial stenosis, the treatment concept of the recovery of the blood flow of stenotic arterial territory by mechanical recanalization or bypass surgery would be remained for the prevention as well as treatment of ischemic stroke caused by intracranial atherosclerosis.