• Journal of Chest Surgery
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• v.23 no.1
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• pp.174-177
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• 1990

Aortic dissection is a challenging disease and the causes of that are well-known. Blunt chest trauma is one of the causes of aortic dissection. In such cases, nearly all cases involves the isthmic portion of descending aorta, but ascending aorta is involved in about 10. We experienced a patient who had ascending aortic dissection due to automobile accident and who showed spontaneous rupture of the aorta during operation. In this case, after installation of aortic line via left femoral artery, ascending aorta ruptured and a large amount of blood gushed out, which was suckered by cardiotomy sucker. A little delay of cardiopulmonary bypass may cause the fatal outcome in such a case because the bleeding from aorta is too much to be controlled. Fortunately, we controlled the bleeding with cardiopulmonary bypass and got the good outcome of this patient by interpositioning the vascular graft. One should suspect the possibility of aortic dissection in blunt chest trauma, and prepare all the facilities against bleeding due to rupture.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.159-162
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• 2008

Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.10-16
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• 1988

Ten patients with tetralogy of Fallot were studied angiocardiographically before a modified Blalock-Taussig shunt and again 25*3.2 months after the previous shunt. All of ten patients had patent previous shunt at the time of follow up examination. Pre-and postoperative diameters of left and right pulmonary artery and descending aorta were measured and pulmonary artery index [the sum of the crossectional areas of the right and left pulmonary arteries standardized by the body surface area] was calculated. The ratio of mean diameter of left and right pulmonary arteries to the diameter of the descending aorta [LPA+RPA/2xDA] was increased postoperatively by 0.20*0.068 [p=0.020]. Mean PAI [pulmonary artery index] increased from 283.8*178.4 mm/m2 BSA to 345.8~144.5 mm/m2 BSA after shunt operation [p=0.019]. This results suggested that the modified Blalock-Taussig shunt was effective to help growth of the pulmonary arteries in most cases of the study populations but the ones with the PAI>233mm*/m* BSA appeared less benefited by Blalock Taussig shunt. Calculation of PAI could be an aid to making a decision whether to perform a one stage corrective surgical procedure or a palliative shunt procedure in the patient with small pulmonary arteries.

• Journal of the East Asian Society of Dietary Life
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• v.15 no.5
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• pp.606-612
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• 2005

This study was performed to provide basic data that predict the application of Saengmaegsan(SMS) as medicinal food. SMS has been used in oriental medicine for many years as a therapeutic agent for cerebral disease. We examined the effects of SMS on physiological function in isolated abdominal aorta and femoral artery from rabbit and measured the changes of regional cerebral hood flow(rCBF), which was continually monitored by laser-doppler flowmeter and pressure transducer in anesthetized adult Spargue-Dawley rats through the data acquisition system composed of MacLab and Macintosh computer. The contraction forces by injection of norephinephrine in isolated abdominal aorta and femoral artery were significantly decreased in each concentration of SMS treatment compared with control. rCBF was increased by SMS in a dose-dependent manner. These results suggest that SMS causes a diverse response of rCBF and arterial diameter. These mechanism in rCBF increase may be mediated by prostaglandis, cyclic GMP and adrenergic $\beta-receptor$. Also mechanism in artery contraction decrease is also mediated by prostaglandis and cyclic GMP. These results indicate that SMS can be nsed as a safe and clinically applicable as a supplementation of diet therapy for cerebral cardiovascular disease patients.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.620-624
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• 1984

The optimal surgical management of the coarctation of the aorta associated with ventricular septal defect is still debated. Sixteen patients with the coarctation of the aorta and VSD were operated upon between November, 1980 and September 1984 at Seoul National University Hospital. They were 11 males and 5 females. All presented between 5 months and 11.5 years of age [mean= 5.5 years]. Presenting symptoms were congestive heart failure in 11 [69%], cyanosis on crying in 3 [19%], and frequent upper respiratory infection in 2 [13%]. In all cases two-stage operation was applied except one in which one stage procedure was taken. Resection and end-to-end anastomosis was used in 3, Dacron graft in 5, Gortex graft in 1, and left subclavian flap angioplasty in 4. Remaining two were missed on the operating table before correction of the coarctation of the aorta. Overall operative death in repair of the coarctation of the aorta were 3[20%]. Among the 12 survivors after repair of the coarctation of the aorta, 4 required patch closure of VSD, 2 required primary closure, 2 showed spontaneous closure [17%], one [8%] showed decrease in its size, 3 were under observation. It might be safe to approach the coarctation of aorta plus VSD with initial repair of the coarctation of the aorta without banding of main pulmonary artery and later management of VSD as usual manner in simple VSD.

• The Korean Journal of Pharmacology
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• v.15 no.1_2 s.25
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• pp.29-37
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• 1979

The tension-length relationships and reactivity of vascular smooth muscle in longitudinal strips from portal vein ana in helical strips from thoracic aorta and pulmonary artery of normotensive control and cadmium-hypertensive rabbits were studied in vitro. 1. The mean arterial pressures of non-poisoned control rabbits was $87.0{\pm}4.7 mmHg$. However, Cd-poisoned group revealed the significant increase in pressure by $109.04{\pm}2.8 mmHg$ (p<0.005). 2. By tension-length studies, strips from portal vein of Cd-poisoned group stretched a greater percent increase in length in response to an applied resting force from 0.25 to 5 g than did those from non-poisoned group. On the contrary, strips from thoracic aorta of Cd-poisoned group showed less compliant than those from control, i.e. the former underwent a less percent increase in length than the latter. Passive tension-length relations of pulmonary artery was unaffected by Cd-hypertension. 3. The force of contraction(active tension) was significantly lowered in strips from aorta of Cd-hypertensive group throughout the range of $0.5{\sim}2g$ passive tension. However, there was no significant difference in the development of active tension of portal vein or pulmonary artery of both groups. 4. The $K^+$-contraction in the portal vein, aorta and pulmonary artery of Cd-poisoned group made no difference in the active force from those of control group. 5. The force of contraction in the strips from aorta of Cd-poisoned group was significanty decreased compared to that of control. The results suggested that the alterations in vascular reactivity to contracting substances and in distensibility to passive tension were induced in the Cd-hypertensive rabbits.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1487-1491
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• 1992

The renovascular hypertension is a rare disease in which obstructive lesion of renal artery results in hypertension and it is the most common surgically curable form of hypertension. Recently, we experienced two cases of renovascular hypertension treated successfully with resection of the stenotic segment and end-to-side reanastomosis of the renal artery to the aorta in one case, and with resection of the stenotic segment and saphenous vein bypass graft in the other case at the Thoracic & Cardiovascular Surgery, Chungnam National University Hospital. Pathologic examinations revealed fibromuscular dysplasia of the medial layer of the renal artery in both cases

• Journal of Chest Surgery
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• v.26 no.11
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• pp.886-889
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• 1993

The DiGeorge syndrome is a rare congenital anomaly of absent or hypoplastic thymus and parathyroid glands. Authors experienced a case of DiGeorge syndrome with complex cardiac anomaly. The complex cardiac anomaly was tetralogy of Fallot with origin of the right pulmonaly artery from the posterolateral ascending aorta.His face showed hypertelorism,short philtrum,"fish-like"mouth and micrognathia. This patient underwent total correction of tetralogy of Fallot and end-to-side anastomosis between right pulmonaly artery and side of main pulmonaly artery. He expired on postoperative second day due to right heart failure and hypoxia.d hypoxia.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.245-248
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• 1993

Recently we experienced a case of Takayasu`s arteritis involving the major aortic branches. A 30 year-old female patient admitted with the complaints of dizziness, visual disturbance, headache and tingling sensation of upper extremities. Aortogram revealed nearly complete obstruction of the origin site of both common carotid arteries and right vertebral artery, and irregular luminal narrowing of the origin site of innominate artery and left subclavian artery, but opacification of right subclavian artery and left vertebral artery. Successful surgical treatment was accomplished with a bypass from the ascending aorta to the left common carotid artery using a tube graft. The left subclavian artery and right axillary artery were revascularized distal to the stenosis with tube grafts that extended from the aortic graft. Postoperative complications were atelectasis, lymph leakage and left phrenic nerve palsy. She discharged uneventually at postoperative 22 days and most of symptoms were relieved.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.256-264
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• 1989

Modified Blalock-Taussig operation remains the standard technique of systemic-to-pulmonary artery shunt in patients of congenital heart disease with decreased pulmonary blood flow. We reviewed the 41 patients who had been performed modified Blalock-Taussig operation from March 1985 to Feb. 1988, and angiographically measured pulmonary artery size before and after shunt, and calculated pulmonary artery index [PAI] and ratio of left and right pulmonary artery to descending aorta[[LPA+RPA]/dAo]. The mean duration of palliation after shunt operation was 624 days and mean age of the patient at shunt operation was 3.59 years. Mean PAI increased significantly from 131.15*67.11 mm2/M2 preoperatively to 232.70*84.46 mm2/M2 postoperatively. Mean ratio of right and left pulmonary artery to descending aorta also increased significantly from 1.48*0.40 preoperatively to 1.92*0.50 postoperatively. All patients manifested clinical improvement; there was mean decrease in hematocrit of 8.95%, mean increase in arterial oxygen saturation of 11.08%. Pulmonary arterial growth was not influenced by age at operation, initial pulmonary artery size, or graft size, but significantly influenced by antegrade flow. The patients who have some antegrade flow were in more increase of PAI. There were no linear correlation between change of PAI, change of [[LPA+RPA]/dAo], SaO2, and duration. But, according to Scatterplot between change of PAI and duration, some complex correlation was suggested and mean PAI was decreased after 2-year palliation. We concluded that modified Blalock-Taussig operation is excellent palliative surgery for pulmonary artery growth especially on the patient who have some antegrade flow, and the proper duration of palliation was about 2 years.