• Title/Summary/Keyword: constrictive

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Clinical review of four patients of acute purulent pericarditis (급성 화농성 심낭염의 외과적 고찰)

  • Kim, Su-Seong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.263-268
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    • 1984
  • Four patients of acute purulent pericarditis were seen at the Jeonbug National University Hospital between January, 1979 and December 1983. All patients were proven to have acute purulent pericarditis by clinical evaluation, bacterial study, and biopsy. Three patients were male and one female. The three patients were in pediatric age. The primary focuses were meningitis, Rt. coxitis, lobar pneumonia, and gastro-enteritis. The causative organisms were staphylococcus aureus in two patients. In the other two patients, organisms were not cultured from the pericardial pus. The reason why the causative organisms were not cultured in pericardial pus was probably due to massive antimicrobial treatment before pus collection. All patients were treated with systemic antibiotic therapy and pericardiostomy with normal saline irrigation. The three patients were treated without specific complication. The one patient developed the chronic constrictive pericarditis. In this patient, pericardiectomy was performed.

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Intrapericardial Tuberculous Abscess Invading Myocardium - A Case Report - (심근내로 파급된 심낭내 결핵성 농양 수술 치험 1례)

  • 김현경
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1245-1249
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    • 1992
  • Tuberculosis developed in the pericardium usually occurs as diffuse constrictive pericarditis or effusive pericarditis which contains much pericardial effusion. But types such as localized abscess or tuberculoma are very rare. Myocardial tuberculosis is also very rare and mainly extended directly from hilar lymph node or spreaded hematogenously in miliary tuberculosis. It is known to be able to make arrhythmia or heart failure by invasion of conduction system or myocardial muscle mass, but it is usually discovered by incidental postmortem autopsy and rarely concerned by clinical basis. Recently we have experienced a case of localized intrapericardial tuberculous abscess which extended to myocardium and operated that successfully. So we would report them with reference study.

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Dynamic Lumbar Spinal Stenosis : The Usefulness of Axial Loaded MRI in Preoperative Evaluation

  • Choi, Kyung-Chul;Kim, Jin-Sung;Jung, Byung-Joo;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.265-268
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    • 2009
  • Two cases of dynamic lumbar spinal stenosis were identified by the authors using axial loaded magnetic resonance image (MRI). In both cases, the patients presented with neurogenic claudication but MRI in decumbency showed no definite pathologic condition associated with their symptoms. In contrast, axial loaded MRI demonstrated constrictive spinal stenosis and a significantly decreased dural sac caused by epidural fat buckling and thickening of the ligamentum flavum in both cases. In the second case, a more prominent disc protrusion was also demonstrated compared with decumbent MRI. After decompressive surgery, both patients had satisfactory outcomes. Axial loaded MRI can therefore give decisive information in dynamic spinal disorders by allowing simulation of an upright position.

Band-like Annular Pericardial Calcification -A case report - (띠 모양의 윤상 심막 석회화)

  • 조양현;류세민;조종호;손영상;최영호;김요한;김학제
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.452-455
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    • 2004
  • We report a case of a 40-year-old woman whose right ventricular out-flow tract was moderately obstructed by a heavily calcified pericardial ring. It was passing over the base of pulmonary artery and mid-portion of left ventricle but the other parts of the pericardium was mildly fibrotic. The pericardium and calcified ring were completely removed under cardiopulmonary bypass. The patient was recovered uneventfully and we could not find the specific cause of calcified pericardial ring.

Surgical treatment of acute purulent pericarditis: report of 14 cases (급성 화농성 심낭염 14례 보)

  • Jo, Geon-Hyeon;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.257-262
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    • 1984
  • Acute purulent pericarditis, though not common in incidence after introduction of antibiotics, is still potentially life treating isease. Since 1971, we have experienced 14 cases of acute purulent pericarditis with successful treatment. Among these 14 cases, 9 cases were male and they had high occurrence on their third to fifth decades in age distribution. Isolation of causative organisms were obtained in 11 cases through the bacterial culture of infectious source which was mainly pericardial effusion or blood, and the most frequently recovered organism was the staphylococcus aureus. Pre-existing inflammatory disease preceding to pericarditis, named as antecedent disease, were proved in 12 cases, and among which contiguous extension from the intrathoracic infection such as pneumonia or empyema accounted for the majority of antecedent disease. Pericardiocentesis with administration of antibiotics were tried in all cases, but result in recovery in 1 patient only. Remaining 13 cases had persistent picture of pericarditis and necessitated surgical drainage procedure. Ten of these 13 cases were underwent the open pericardial window using a mode of anterior approach in 4 and subxiphoid approach in 6 cases respectively. Two cases of subxiphoid group were reoperated by the anterior interphrenic pericardiectomy, due to insufficient drain of too thick effusion. In remaining 3 cases, anterior interphrenic pericardiectomy was performed initially because of purulent effusion already changed into fibrinopurulent peel with thickened pericardium. Through the experience of this series, we recommended that pericardiectomy should not be reluctant in purulent pericarditis as a initial surgical procedure for advantage of complete removal of infected space and avoidance of late constrictive pericarditis.

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Multi-loculated Pericardial Mesothelioma -A case report- (심막에 발생한 다발성 중피종 1예)

  • Yang, Hong-Seok;Hwang, Jung-Joo;Joo, Hyun-Cheol;Lee, Mi-Kyeong;Paik, Hyo-Chae;Cho, Sang-Ho
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.392-395
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    • 2005
  • Primary pericardial mesothelioma is extremely rare and the incidence is low among the mesotheliomas that originate from other parts of the body. The prognosis of the tumor is unfavorable due to its late presentation, difficulties in early diagnosis and complete resection, and the limited treatment options. Herein, we report a case of pericardial mesothelioma. The patient is a 55-year-old woman who presented with chronic cough and dyspnea. During the examination, pericardial effusion was found and pericardial window formation was followed. She visited our hospital because of persistent dyspnea, with right shoulder and chest pain. Four discrete masses were discovered in the chest CT. CT guided-fine needle aspiration biopsy was negative for malignancy. Right exploratory thoracotomy and partial resection of 3${\times}$3 cm mass abutting pericardium was performed and was histologically diagnosed as malignant mesothelioma, biphasic type. Pericardial mesothelioma is rare, but it should be remembered as an important differential diagnosis in patients with persistent pericardial effusion and symptoms of dyspnea and constrictive pericarditis.

The Changes of Metabotrophic Glutamate Receptor Type 5 in Allodynia Induced by Nerve Ligation (신경결찰로 인한 이질통에서 Metabotrophic Glutamate 5형 수용체의 변화에 대한 연구)

  • Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.8-15
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    • 1999
  • Following peripheral nerve injury, rats will show a tactile allodynia and hyperalgesia. But the mechanism of allodynia is still obscure. The present studies, using rats rendered allodynia by loosely constrictive ligation of the common sciatic nerve (Bennett Model) and tight ligation of L5 & L6 spinal nerve (Chung Model), aimed to investigate the changes of metabotrophic glutamate receptor type 5 on the development of tactile allodynia. Male Sprague-Dawley rats (130~200 g) were anesthetized with halothane, the rats were randomly divided into one of these three groups, Group 1 (Sham operation), Group 2 (Bennett model) and Group 3 (Chung model). Seven days after surgical procedure, the animal was reanesthetized and decapitated. The spinal cord was quickly removed and stored at deep freezer for polymerase chain reaction (RT-PCR). In Group 2&3, rats showed that tactile allodynia checked by up-down method with calibrated 8 von Frey hair. The level of gene expression of mGluR5 mRNA was significantly increased in group 2 and 3. These increases was significantly different from sham operation, group 1. It was also showed that the increasing patterns of group 2 and 3 in the gene expression were similar correlation with the results of the threshold for tactile allodynia on von Frey hair test. Even though there were some differences between Bennett model and Chung model, these results suggested that mGluR5 had partly attributed to making a tactile allodynia from these models.

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On Exploiting New Methods of Language Acquisition Offered by the Internet (인터넷이 제공하는 언어 습득의 새로운 방법 활용)

  • Choi, Mi-Hee Michelle
    • Journal of Digital Contents Society
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    • v.14 no.1
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    • pp.111-116
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    • 2013
  • Instructive lessons in the language classrooms are extremely constrictive to language learners in improving their English skills, thus, the use of technology in education plays an important role in a language classroom. Results of language proficiency improvement of the learners vary depending on the extent of supplementary materials offered by the internet delivered to the learners. The purpose of the present study is to explore and propose a new approach of language acquisition offered by the internet. This study presents effective methods of using the internet in carrying out the written work. In this paper, we show that the relationship between participation of the learners in the class activities and improvement of English writing skills are mutually proportional.

Cardiovascular Surgery in Korea (한국의 심장혈관수술 현황)

  • 김형묵
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.371-382
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    • 1985
  • Over the past 4 decades after World War II a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of congenital and acquired cardiovascular diseases in Korea. Clinical data on cardiovascular surgical cases performed in all 22 hospitals for open heart surgery in Korea was collected from it`s starting up to December 1984. The first recorded open heart surgery for a young adult atrial septal defect was performed by Young Kyoon Lee, M.D. on August 7, 1959, Seoul National University Hospital, Korea. And, some scattered reports on cardiovascular surgical cases in it`s early period have changed recently the number of hospitals for open heart surgery and clinical cases enormously in total amount of 13, 100 cardiovascular operations performed on 12, 990 cases up to December 1984. Of the total 13, 100 cardiovascular operations, congenital cardiovascular anomaly occupied 70%. Of the congenital cases, 6, 580 operations for acyanotic group [operative mortality 4.5%], and 2, 489 operations for cyanotic group [operative mortality 20%]. The incidence of congenital cardiovascular anomaly in order of frequency was ventricular septal defect [29%], patent ductus arteriosus [26%], Tetralogy of Fallot [22%], atrial septal defect [8, 6%], pulmonary valve stenosis [3.0%], and endocardial cushion defect [1.1%]. Of the 3, 412 valvular heart disease cases, which occupied 85% of total 4, 031 acquired cardiovascular disease, individual incidence was in mitral 2, 565 [63.5%], double valve 451 [11.1%], and simple aortic valve 351 [8.7%]. Total number of valve replaced, mechanical and tissue, was 2, 795, and 1, 884 for mitral, 808 for aortic, and 103 for tricuspid in position. Operative mortality for prosthetic valve replacement in total was 9.8%. Remained acquired cardiovascular cases chronic constrictive pericarditis [7.9%], cardiac tumor [1.9%], coronary artery bypass [1.8%], cardiac trauma [1.2%] and less than 1% of thoracic aortic aneurysm. Overall operative mortality for open and non-open cardiovascular surgical operation was 7.7% [congenital acyanotic group 3.2%, congenital cyanotic group 19.4%, and acquired group 7.8%]. In conclusion, present status of cardiovascular surgery in Korea is stabilized with accumulation of clinical cases and experiences, and the future in the field of cardiovascular surgery is promising, especially in the infant cardiac surgery and aortocoronary bypass surgery, with abrupt increase of specialized cardiac centers, trained specialists, and expanding social health insurance.

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Clinical Analysis of Cardiac Valve Surgery (심장판막증의 외과적 치료)

  • 김형묵
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.446-455
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    • 1985
  • A total and consecutive 156 patients have undergone cardiac valve surgery including 13 closed mitral commissurotomy, 13 open mitral commissurotomy, one mitral annuloplasty, 75 mitral valve replacement, one aortic annuloplasty, 24 aortic valve replacement, 3 tricuspid valve replacement, 25 double valve replacement and one triple valve replacement. 155 prosthetic valves were replaced in a period between September 1976 and August 1985. There were 68 males and 88 females with age range from 8 to 69 yrs [mean 36.5 yr]. Out of replaced valves, 61 was tissue valve including 54 Carpentier-Edwards, and 4 was mechanical valves including 74 St. Jude Medical, and the position replaced was 101 valves for mitral, 46 for aortic and 8 for tricuspid. Single valve replacement in 102 cases, double valve replacement in 25 cases [17 for AVR+MVR, and 8 for MVR+TVR], and only one case was noted in the triple valve replacement. Early mortality within 30 days after operation was noted in 11 cases [7%]; 7 after MVR, 2 after DVR, and each one after open mitral commissurotomy and mitral annuloplasty. Cause of death was valve thrombus, cerebral air embolism, low output syndrome, uncontrollable arrhythmia, parapneumonic sepsis, acute cardiac tamponade and left atrial rupture. 7 late deaths were noted during the follow-up period from 1 to 104 months [average 48 month]; three due to valve and left atrial thrombus formation, two due to CVA from overdose of warfarin, and each one due to congestive heart failure and chronic constrictive pericarditis, Anticoagulants after prosthetic valve replacement were maintained with warfarin, dipyridamole and aspirin to the level of around 50% of normal prothrombin time in 79 cases, and Ticlopidine with aspirin in 47 cases to compare the result of each group. There were 11 major thromboembolic episodes including 3 deaths in the warfarin group. Two cases of CVA due to overdose of warfarin was noted in the warfarin group. In the ticlopidine group, there was only one left atrial thrombus confirmed at the time of autopsy. Among the survived 138 cases, nearly all cases[136 cases] were included in NYHA functional class I and II during the follow-up period. In conclusion, surgical treatment of the cardiac valve disease in 156 clinical cases revealed excellent result with acceptable operative risk and late mortality. Prevention of thrombus formation with anti-platelet aggregator Ticlopidine has better result than warfarin group presently with no specific side effect such as bleeding or gastrointestinal trouble.

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