• The Korean Journal of Nuclear Medicine
• /
• v.31 no.1
• /
• pp.43-49
• /
• 1997

We studied to investigate the predictive values of gated SPECT for the improvement of wall motion after bypass surgery. As we compared postoperative SPECT with preoperative ones, we defined viability as wall motion improvement. We peformed rest T1-201/s1ress Tc-99m-MIBI gated SPECT in 25 patients before and 3 months after bypass surgery. Myocardial wall motion was graded as normal, hypokinesia, akinesia, and dyskinesia by pair-wise visual analysis of gated pre and postoperative SPECT's on the same monitor screen. Myocardial wall thickening was determined good or poor Among 92 segments with wall motion abnormalities before operation, 69 (75%) improved and 23 did not. Before operation, we could find segments with good systolic thickening in 64 segments among total 92. Thickening of the remaining 28 was poor. Wall motion improved postoperatively in 45 segments (70%) among 64 with good thickening. Twenty four(86%) among 28 segments with poor thickening had also improved. We grouped segments into mild(hypokinetic) and severe(akinetic/dyskinetic) ones. Among 33 segments with severe motion abnormalities, 14 had good thickening and 19 did not. Nine(60%) improved out of 14 segments having severe abnormality with good thickening However, 16(84%) segments out of 19 haying severe abnormality with poor thickening also improved. Neither degree of perfusion decrease nor severity of wall motion abnormalities could explain the high rate of false negatives. In conclusion, as we defined viability as wall motion improvement by comparing pre and postoperative SPECT, systolic thickening observed by gated Tc-99m-MIBI SPECT in myocardial segments with wall motion abnormalities predicted wall motion improvement after bypass surgery. However, poor thickening could not be referred as evidence of nonviable myocardium both in mild and severe contractile dysfunction, so that we might need stimulation study such as dobutamine echocardiography or dobutamine gated SPECT.

• Journal of Chest Surgery
• /
• v.24 no.9
• /
• pp.913-917
• /
• 1991

Ventricular septal defect complicating myocardial infarction is rare but fatal condition which requires early surgical intervention before end-organ failure ensues from cardiogenic shock. Since the first successful repair by Cooley et al in 1956, surgical skills and strategies were developed and modified to a great extent, and we adopted the new repair technique in our case which stresses that minimal or no part of the infarcted septum and left ventricular wall be resected. This technique obviates the need to resect the infarcted part of the septum and prevents recurrence of an even larger VSD, and provides adequate size and shape of the left ventricle after of transinfarction left ventriculotomy.

• Journal of Chest Surgery
• /
• v.28 no.3
• /
• pp.324-327
• /
• 1995

Extracranial carotid artery disease is rare and closely related to cardiovascular morbidity and mortality.We experienced one case of surgical treatment of left common carotid artery stenosis using internal shunt.The patient was 54-year-old female presented as headache and dizziness for about 2 years.On Doppler ultrasound, an atheromatous plaque was noted along the posteromedial wall of left common carotid artery resulting in luminal narrowing in about 75s of cross section area.The atheroma was resected through carotid endarterectomy, measured about 5.2cm in length. Postoperative course was uneventful and she was discharged in good condition.

• Journal of Chest Surgery
• /
• v.33 no.5
• /
• pp.432-435
• /
• 2000

We report a case of primary undifferentiated cardiac sarcoma. The tumor originated from the left atrial free wall with multi-organ metastases, e.g., lung, and adrenal gland. The patient gradually grew worse with dyspnea and hemoptysis because of the obstructed left atrial outflow. Surgical resection of the left atrial sarcoma was undertaken to save the patient's life, followed by chemotherapy and brain irradiation as adjuvant therapy. The prognosis of cardiac sarcoma with metastases is very poor. However, in patients with hemodynamic instability, surgical intervention could be a therapeutic modality as palliation.

• Journal of Chest Surgery
• /
• v.20 no.3
• /
• pp.578-581
• /
• 1987

A very rare form of intrapulmonary cyst is an enterogenous cyst two examples of which were described by Ward and Krahl [1942]. Microscopically, the cyst wall is lined by gastric or intestinal type of mucous membrane which may include islets of pancreatic tissue; their walls contain muscle but no cartilage. We recently experienced a case of intrapulmonary enterogenous cyst. The patient was 30-year-old-male who showed chest pain and tightness after chest trauma. Chest X-ray revealed pneumothorax in both lung field with giant bullae in left upper lung field, right 6th and 7th rib fracture. Left lower lobectomy including cyst was done and the postoperative course was uneventful.

• Journal of Chest Surgery
• /
• v.15 no.3
• /
• pp.325-330
• /
• 1982

A case of a 7 year old girl with rare congenital anomalies is reported. The anomalies as called Cantrell`s pentalogy is consisted of defect in supraumbilical abdominal wall, ventral diaphragm, adjacent pericardium, and lower sternum associated with cardiac malformation. Her cardiac lesion was muscular diverticulum of left ventricle. The diverticulum was resected and the other defects were repaired successfully.

• Journal of Chest Surgery
• /
• v.20 no.4
• /
• pp.847-850
• /
• 1987

Traumatic arteriovenous fistula is relatively uncommon. The proper designation for what is called a false aneurysm is pulsating hematoma, which occurs when there is a small laceration of the wall of a large artery will continuing leakage of blood from the artery into surrounding tissues. The extent of growth of the pulsating hematoma depends on the strength of the surrounding fascial tissues. We experienced one case of arteriovenous fistula with hematoma, due to operative injuries, and operated successfully, and report the case.

• Journal of Chest Surgery
• /
• v.29 no.1
• /
• pp.95-98
• /
• 1996

We report a case of primary cardiac fibroma which is a rare cardiac neoplasm and arising most frequently from right ventricular free wall and interventricular septum. A 2-month-old male infant with cyanosis was admitted for evaluation and treatment. Echocar-diographic lEnding was a cardiac mass. Successful nearly total removal of the tumor was performed. The pathologic result was compatible with fibroma. The postoperative course was not eventful, and have been in good condition upto now.

• Journal of Chest Surgery
• /
• v.20 no.2
• /
• pp.399-403
• /
• 1987

Ewing`s sarcoma is a highly malignant tumor which occurs most frequently in the diaphysis of the long bones, although any bone may be involved. Ewing`s sarcomas occurring in the rib are rare. Recently, we experienced one case of Ewing`s sarcoma which arose in the right second rib in a young female patient. She was treated with three principal treatment modalities-en bloc excision of chest wall followed by radiation therapy and chemotherapy. Clinical course is described with review of related literatures.

• Journal of Chest Surgery
• /
• v.24 no.3
• /
• pp.292-295
• /
• 1991

Pulmonary sequestration is a rare congenital malformation of the lung and occasionally accompanied with upper gastrointestinal anomalies. Based on the embryologic development, they are grouped as broncho-pulmonary foregut malformation. We present one the case of the intralobar pulmonary sequestration with gastric duplication. The sequestrated pulmonary tissue was 9x7x8cm in dimension, multiseptated and multiloculated, and supplied by a systemic artery of 7mm diameter from the abdominal aorta. The gastric duplication was 8cm in diameter located at the posterior wall of the stomach without communication with the gastric lumen.