• Journal of Chest Surgery
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• 제18권2호
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• pp.258-264
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• 1985

The experience with operative treatment for total correction of Fallot at the department of Thoracic and Cardiovascular Surgery, Keimyung University Dong San Medical Center from July 1980 to July 1984 was reviewed. There were 37 males and 12 females and their ages ranged from 3 years to 30 years, with the average age of 12.2 years. Sixty nine point four percent of patients were younger than 15 years of age. The most frequent type of right ventricular outflow stenosis was the combined type [pulmonary valvular and infundibular stenosis] containing 41 patients [83.7%] and there were 9 deaths in this group. The major associated lesions included Patent foramen ovale in 20 patients [40.8%], Atrial septal defect in 7 patients [14.3%], Left superior vena cava in 4 patients [8.2%], Right sided aortic arch in 2 patients [4.1%] and Patent ductus arteriosus in 11 patient [2.0%]. The pulmonary valvotomy was performed in 41 patients and patch graft reconstruction of the right ventricular outflow tract was performed in 23 patients. In 11 patients the monocusp patches were used. Thirty-five patients [71.4%] had the right bundle branch block postoperatively. There were 11 postoperative deaths with hospital mortality rate of 22.4% and the leading causes of death were low output syndrome, bleeding, and cerebral embolism.

• Journal of Chest Surgery
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• 제10권1호
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• pp.98-105
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• 1977

A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

• Journal of Chest Surgery
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• 제47권2호
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• pp.117-123
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• 2014

Background: Implanted venous access devices or permanent central venous access systems (PCVASs) are routinely used in oncologic patients. Complications can occur during the implantation or use of such devices. We describe such complications of the PCVAS and their management. Methods: Our retrospective study included 1,460 cases in which PCVAS was implanted in the 11 years between January 2002 and January 2013, including 810 women and 650 men with an average age of 45.2 years. We used polyurethane or silicone catheters. The site of insertion and the surgical or percutaneous procedure were selected on the basis of clinical data and disease information. The subclavian and cephalic veins were our most common sites of insertion. Results: About 1,100 cases (75%) underwent surgery by training surgeons and 360 patients by expert surgeons. Perioperative incidents occurred in 33% and 12% of these patients, respectively. Incidents (28%) included technical difficulties (n=64), a subcutaneous hematoma (n=37), pneumothoraces (n=15), and an intrapleural catheter (n=1). Complications in the short and medium term were present in 14.2% of the cases. Distortion and rupture of the catheter (n=5) were noted in the costoclavicular area (pinch-off syndrome). There were 5 cases of catheter migration into the jugular vein (n=1), superior vena cava (n=1), and heart cavities (n=3). No patient died of PCVAS insertion or complication. Conclusion: PCVAS complications should be diagnosed early and treated with probable removal of this material for preventing any life-threatening outcome associated with complicated PVCAS.

• Neonatal Medicine
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• 제16권1호
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• pp.71-75
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• 2009

9번 염색체 장완의 중복은 거의 드문 형태의 염색체 이상이며, 특징적인 얼굴형태와 손가락 형태, 정신지체 등이 나타나는 것으로 알려져 있다. 얼굴 형태는 정상이었으나 선천성 심장기형과 수신증, 음낭 탈장이 동반된 미숙아에게서 46,X,Y,dup(9)(q21.2q22.1)를 확인하였고, 표현형이 정상인 환아의 아버지에게서 유래된 것으로 생각되어진 예를 경험하였기에 보고하는 바이다.

• 대한핵의학회지
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• 제6권2호
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• pp.21-39
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• 1972

The employment of gamma-ray scintillation camera with the use of short-lived radioisotopic pharmaceuticals, sucu as $^{99m}Tc$ sodium pertechnetate, have enabled us to perform RI (radioisotopic) angiocardiography. Although conventional cardiac catheterization or angiocardiography using contrast media have been an important diagnostic tool, they may carry some risks or serious complications. The author investigated on RI angiocardiography in twelve normal and twenty five patients with cardiovascular diseases in an effort to evaluate its diagnostic value. The results obtained with this study are as follows; 1. In normal subjects, the scintillation camera transit time of arm-to-right heart was found to be $2.1{\pm}0.67$ seconds, right heart-to-lung $1.5{\pm}0.40$ seconds and lung-to-left heart $3.5{\pm}0.86$ seconds. 2. Transformation or displacement of the heart and the great vessel are easily discriminated by RI angiocardiography. Both in the cases with tricuspid atresia and tetralogy of Fallot, ventricular septal defects are well recongnized by sequential RI angiocardiography. 3. It is also helpful in determinining the site and extent of obstruction, and estimatiing the postoperative course both in the cases with superior vena cava syndrome and pulmonary stenosis. 4. Pericarditis with effusion is readilly diagnosed by RI angiocardiogram showing characteristic "dead space" between intracardiac and intrapulmonary radioactivity. 5. It was found that the diagnostic accuracy of this study was 78.4%. It is concluded that above results obtained are useful and accurate enough for the diagnostic screening methode for clinical practice.

• Radiation Oncology Journal
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• 제11권1호
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• pp.97-102
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• 1993

1983년 4월부터 1991년 9월까지 가톨릭 의과대학 강남성모병원 치료방사선과에서 국한된 폐소세포암으로 확진되어 방사선치료받은 32명의 환자를 대상으로 치료성적을 후향 분석하였다. 이중 5명은 방사선 치료 단독으로 치료받았으며 27명은 화학요법과 방사선치료 병용요법을 하였다. 남녀의 비는 4.3:1 이었으며 연령분포는 24세에서 78세였다(중앙값 : 63세). 6 MV X 선에의한 방사선치료선량은 일일 160-180 cGy씩 치료하여 총 1000-6660 cGy (중앙값 4500 cGy)였다. 치료 후 완전관해율은 $37.5{\%}$ (12/32), 부분관해율은 $34.4{\%}$(11/32)였고, 무반응은 $28.1{\%}$(0/32)였다. 생존기간의 중앙값은 10개월이었고 1년생존율과 2년생존율은 각각 $59.4{\%}$와 $28.1{\%}$였다. 1년생존율을 유의하게 증가시키는 요소로서는 70이상의 Karnofsky수행상태(p<0.04), 화학요법의 병행(CAV, PV, CAV+PV) (p<0.04), 화학요법 6회 이상(p<0.007) , 45 Gy 이상의 방사선량(p<0.03)와 방사선치료에 반응있었던 경우(CR+PR) (p<0.003)등이었다. 나이, 성별, 상대정맥증후군, 예방적 전뇌조사 및 방사선 치료기간은 유의한 영향을 미치지 않았다. 방사선 치료에의한 부작용은 식도염이 $34{\%}$(11명), 전신피로 $28{\%}$(9명)에서 있었으며 오심 구토 같은 위장관 증상은 $15{\%}$(5명) 그리고 백혈구감소증이 $3{\%}$(1명)에서 관찰되었다.