• Journal of Chest Surgery
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• v.49 no.4
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• pp.325-328
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• 2016

The late Prof. Kyeok Boo Han (1913-2005) was one of the pioneers in the early stages of the establishment of thoracic surgery in Korea. He was in charge of thoracic surgery at Seoul National University Hospital from 1948 to the outbreak of the Korean War in 1950. He presented a thoracic surgical case entitled "Adhesive (constrictive) pericarditis: one surgical case" at the first academic meeting of the Chosun (an old name for Korea) Medical Association, held in 1947. This presentation is considered to be the first thoracic surgical case presented by a Korean surgeon at a domestic medical meeting after the National Liberation from Japanese colonial rule in 1945. In this regard, this study was intended to analyze the content and the meaning of the case, published in a journal in 1948.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.648-651
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• 2005

Calcific constrictive pericarditis is considered to be a nonspecific response to chronic inflammation. This disease has become rare, because the cause of it is usually tuberculosis, which has the tendency to decrease. Other possible causes of it include radiation, rheumatoid disorders, sarcoidosis, and trauma. Whatever the etiology, it can lead to cardiac tamponade by reducing cardiac diastolic filling. We report, herein, the case of a patient with heart failure by a calcific pericardial ring.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.676-682
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• 1990

From August, 1978, to August, 1989, 22 patients underwent pericardiectomy for chronic constrictive pericarditis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 14 male and 6 female patients ranging from 11 years to 70 years old[mean age, 44. 1 years]. All patients underwent radical pericardiectomy through a median sternotomy. There was 1 postoperative death[4.s%]. This patient died of low cardiac output 7 days after pericardiectomy. Postoperative complications were hemothorax[2 patients], low cardiac output[2 patients], generalized seizure[1 patient], wound infection[1 patient] and pneumonia[1 patient]. Clinical and pathological findings showed tuberculous origin in 12 patients[54.6%], unknown etiology in 8 patients[36.4%] pyogenic pericarditis in 2 patients[9.1%]. Three hemodynamic responses to pericardiectomy were observed: [1] rapid response, where central venous pressure[CUP] fell below 10 cmH2O by 24 hours in 6 patients; [2] delayed response. Where CVP fell below 10 cmH2O by 48 hours in 12 patients; and [3] no response of CVP in 4 patients. Follow-up ranged from 6 to 62 months with an average of 35.3 months. Postoperative Functional Class was obtained for 21 surviving patients and showed 18 patients[81.8%] to be New York Heart Association functional class I or II.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.610-613
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• 2003

A 68-year-old man with constrictive pericarditis underwent pericardiectorny. The pericardium was dissected with a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH). The harmonic scalpel differs from electrocautery in that there is only a minimal transfer of energy and no transfer of electrical energy to the tissues. A significant decrease in intraoperative and possibly even postoperative heart rhythm disorders is to be expected, as there is no conduction of electricity. This new device has many advantages including no muscular stimulation, low heat, a smokeless fold and easy hemostasis. We exprienced a patient who underwent pericardiectomy using the Harmonic scalpel, so we report this case with a brief literature.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.973-978
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• 1991

From January, 1982, to December, 1990, 15 patients underwent pericardiectomy for chronic constrictive pericarditis on Department Of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University. There were 9 male and 6 female patients [male to female ratio was 1.5: 1] ranging from 15 years to 63 years old [mean age 35.0]. All patients underwent pericardiectomy through a median sternotomy, partial cardiopulmonary bypass was performed on two patients. There were 3 postoperative death [20%]. Six cases [40%] were tuberculous origin 5 cases [34%] were Idiopathic [nonspecific chronic inflammatory change was considered to idiopathic], 2 cases [13%] were malignant origin, 2 cases [13Yo] were pyogenic origin. Dyspnea on exertion was evident in all patients and abdominal distention, general weakness, palpitation, peripheral edema were found. Eleven patients showed low voltage of QRS wave, 7 patients showed diffuse ST-T wave change, 2 patients showed atrial fibrillation on EKG. There were 6 patient showed pericardial thickening, 5 patients showed evidence of restriction, 5 patients showed pericardial effusion, 4 patients showed low cardiac output on preoperative echocardiogram. Hemodynamic response to pericardiectomy were observed; preoperative CVP 26.8 cmH2O declined to 15.0 cmH2O. Preoperative NYHA Functional class showed class II - 1, class III - 10, class IV - 4, postoperative NYHA functional class showed class I - 7, class II - 4, class Ill - l.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.68-74
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• 1986

15 patients with constrictive pericarditis who underwent interphrenic pericardiectomy from January, 1981 to April, 1983 and 11 patients who underwent radical pericardiectomy from May, 1983 to September, 1984 were compared to the clinical improvement and the results of pre- and postoperative cardiac catheterization. In the group of partial pericardiectomy the pericardium was removed anteriorly from the left phrenic nerve to the right phrenic nerve and in the group of radical pericardiectomy the pericardium was removed from almost entire surface of the heart including diaphragmatic surface and posterior wall of the left ventricle. The following results were obtained. 1. Both group of the patients showed marked symptomatic improvement early after operation. 2. The central venous pressure was decreased significantly after operation in both group of the patients. 3. The right atrial mean pressure and pulmonary arterial mean pressure decreased significantly after operation in both group of the patients and there was no significant difference in the amplitude of decrease between the two groups. 4. The right ventricular end-diastolic pressure and left ventricular end-diastolic pressure were decreased postoperatively in both group of the patients and the patients of the radical pericardiectomy showed more decrease than the patients of interphrenic pericardiectomy, and in the group of radical pericardiectomy the right and left ventricular end-diastolic pressure were normalized postoperatively but in the group of partial pericardiectomy they showed abnormally high pressure persistently. 5. The ejection fraction showed normal level pre- and postoperatively in both group of the patients.

• Journal of Chest Surgery
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• v.1 no.1
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• pp.61-68
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• 1968

In the 10 years from 1958 through 1968, 23 patients have undergone 24 times of operation for constrictive pericarditis at this department. Follow-up data were available for periods varying several months to almost 10 years from examination at this department or follow-up letters. There were 21 males and 2 females in this series. Range of the age varied from 2 years to 53 years. Seven cases were below 15 years of age. There were two hospital death, one expired two weeks and another four weeks after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factors. Clinical and histological study showed tuberculous origin in 12 cases, non-specific chronic infiammatory changes in 8 cases and in 3 cases previous pyogenic pericardial infection by staphylococcus preceded to the constriction. In 11 cases bone tissue was noted microscopically in the pericardium: Sixteen patients[70 %]had pleural effusions, five cases had bilateral, 6 right, and 5 left. Calcification was seen along cardiac border in 9 cases. In 15 catheterized patients, 6 showed pressure gradients between vena cava and right atrium, ranging from 6 mmHg to 10 mmHg. One case was reoperated 3 months after the original operation resulting in marked improvement. In this reoperated case the original pericardiectomy seemed to be incomplete. In 21 cases. excluding 2 hospital death, symptoms and physical findings improved markedly in every patient

• Journal of Chest Surgery
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• v.43 no.4
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• pp.437-440
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• 2010

Cardiac mesotheliomas are rare. It is difficult to diagnose them at an early stage because the symptoms are nonspecific. Here we report two cases that had been initially diagnosed as constrictive pericarditis but later were definitively diagnosed, after pericardiectomy, as mesothelioma. The two patients complained of dyspnea that lasted 4 months and 10 years. Chest CT showed mild pericardial effusion and thickened pericardium, which was found enveloping the heart without any lumps. Median sternotomy showed that the overall pericardium was thickened by more than 10 mm. Pericardiectomy (phrenic nerve to phrenic nerve) was performed and post-operative histology confirmed malignant mesothelioma. In one patient the disease recurred near the pericardium post-operatively at 7 months and the patient died at 11 months. The other patient received chemotherapy and was still alive at post-operative month 16. Pericardial mesothelioma is an extremely rare disease exhibiting clinical signs similar to those of constrictive pericarditis, and should be diagnosed at an early stage of onset.

• Bulletin of the Korean Chemical Society
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• v.18 no.1
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• pp.80-86
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• 1997

Nine new solubility-increased container hosts having eight undecyl substituents were synthesized and characterized. 1H NMR spectral data showed integral inclusion state of carceplexes and their stability. 1H NMR chemical shifts of guest DMA were correlated to the host's cavity dimensions shrinked by constrictive binding. Carceplex and hemicarcerand showed their distinctive FD mass spectra.

• Journal of Chest Surgery
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• v.8 no.2
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• pp.101-108
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• 1975

Since 1959 the authors experienced 43 cases of chronic constrictive pericarditis treated surgically at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seonl. Of 43 cases, detailed patients' records could be obtainable in 36 cases, and most of our studies. were made on the basis of these 36 available cases. About 84 per cent of the cases were male with several pediatric cases, and duration of symptoms ranged between 2 months and 10 years. The diagnosis of this condition is not difficult, however, about half of our cases were previously treated under the impression rf various other conditions such as liver cirrhosis or nephrotic syndrome at other hospitals and clinics. Many of our cases showed hepatic functional disturbances and about 89 per cent of the cases showed reversed A/G ratio, and we are sure that some of them had so-called protein losing enteropathy. Three of 36 cases showed normal electrocardiogram, and most peculiar electrocardiographic findings were ST or T changes and low amplitude of QRS complexes. Seven cases showed auricular fibrillation and five had first degree A-V block. Mean preoperative peripheral venous pressure at the antecubital fossa and arm-to-tongue circulation time were 273 mm $H_2O$and 20.2 seconds, respectively, and they were markedly reduced postoperatively to 152 mm $H_2O$ and 13 seconds, respectively. Several different approaches were made with various extents of pericardial decortication according to patients' condition and probably surgeon's preference. In 12 cases we met cardiovascular injuries during decortication and one of them died of massive bleeding through the torn right atrium, and we experienced excellent postoperative result in a grave case operated on just a small pericardial window. Eleven of 35 cases were tuberculous pericarditis and others were non-specific pericarditis histopathologically, and 6 of total 43 cases operated on passed away by various ways with the mortality rate of 13.9 per cent.