• Title/Summary/Keyword: dyspnea on exertion

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Aortocoronary Bypass Surgery Concomitant with Cardiac Valve Replacement (심장판막 치환술을 병행한 관상동맥 질환의 수술)

  • Kim, Kyung-Hwan;Chae, Hurn;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.187-190
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    • 1994
  • Between March, 1989, and August, 1993, 10 patients underwent aortocoronary bypass surgery concomittant with cardiac valve replacement. They were 6 men and 4 women, the age ranging from 47 to 64. 7 patients underwent single valve replacement and 2 patients underwent double valve replacement, Another one patient underwent only CABG one year after valve replacement and he had no evidence of prosthetic valve failure. Total number of graft vessels were.15,14 were saphenous venous grafts and 1 was internal mammary artery graft. Dyspnea on exertion was frequent symptom and was found in all patients. 8 patients presented stable angina, only 1 patient presented postinfarct angina and another 1 patient presented no angina symptom. The graft was placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout operation. Postoperative course was uneventful and there was no hospital mortality, as was supported by many reports, it is our opinion that simultaneous valve replacement and aortotomy bypass graft does not increase the risk of cardiac valve replacement substantially.

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Muscle Flap Operation in Complicated Bone Tuberculosis Infection -A case report- (골감염을 동반한 결핵 감염에서의 근판 전이술 -치험 1례)

  • 허진필
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.89-91
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    • 1998
  • Tuberculosis infection is wide spread disease and makes troublesome complications in some cases. A 50 - year old male visited Andong Hospital with coughing and sputum, dyspnea on exertion, bulging left anterior chest wall mass. Chest X-ray showed right pleural effusion, both side streaky infiltraion, and pleural thickness in apex. Chest CT scan showed bone destruction of left clavicle head, manubrium and large abscess pocket in pectoralis muscle. In May 1996 he underwent en bloc resection of left upper anterior chest wall including pectoralis major and minor muscle, left clavicle head, manubrium and covering infected skin, then contralateral pectoralis major muscle flap and skin graft was done. Patient shows no evidence of recurrence during follow up.

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Right Lung Mass (우측 폐종괴)

  • Kim, Junhyoung;Han, Minsoo;Kim, Dong Hoon;Ko, Hun;Lee, Yang Deok;Cho, Yongseon
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.570-573
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    • 2003
  • Sarcomatoid carcinomas of the lung are rare malignant biphasic tumors, which contain both a malignant epithelial component and a sarcomatoid component. The majority of patients are men and the mean age of onset is 60 years at the time of diagnosis. A metastasis to the regional lymph nodes and to distant organs is common. The clinical course of patients with this neoplasm is aggressive, with an overall 5-year survival rate approximating 20%. A sarcomatoid carcinoma of the lung is often observed in the large bronchi and peripheral lung field than in the trachea, and the clinical manifestations are related to their specific location. We report a case of sarcomatoid carcinoma of the lung in a 79-year-old man who presented with dyspnea on exertion.

Research Trends of Interstitial Lung Disease (간질성 폐질환의 연구 동향)

  • Son, Ji-Woo;Lee, Jung-Wook;Lee, Byung-Soon;No, Woon-Serb;Lee, Byung-Ju;Shin, Jo-Young;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.13 no.1
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    • pp.26-38
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    • 2007
  • Interstitial lung disease (ILD) is characterized by progressive scarring of the lung leading to restriction and diminished oxygen transfer. Clinically, the presenting symptoms of ILD are nonspecific (cough and progressive dyspnea on exertion) and are often attributed to other diseases, thus delaying diagnosis and timely therapy. In this study, I analyzed the 10 chinese papers of interstitial lung diseases(ILD). The etiology are body resistance weakness(本虛) and pathogenic factor prevailing(標實). The body resistance weakness(本虛) including deficiency of the lung(肺虛), deficiency of the kidney(腎虛), deficiency of the spleen(脾虛), deficiency of Qi and Yin(氣陰兩虛), pathogenic factor prevailing(標實) including stagnation of phlegm(痰濁), blood stasis(瘀血), noxious heat(熱毒). As an treatment aim at supplementing lung and kidney(益肺腎), resolving phlegm and blood stasis(化痰瘀).

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Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adulthood: Challenges and Outcomes

  • Kothari, Jignesh;Lakhia, Ketav;Solanki, Parth;Parmar, Divyakant;Boraniya, Hiren;Patel, Sanjay
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.383-386
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    • 2016
  • Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular arrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system.

Idiopathic multicentric Castleman disease presenting progressive reticular honeycomb infiltration of lung and immunoglobulin G and immunoglobulin G4 dominant hypergammaglobulinemia: a case report

  • Kim, Hyun-Je;Hong, Young-Hoon
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.153-160
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    • 2022
  • Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

Thoracic Fetiform Teratoma: A Case Report of a Very Rare Entity in a Peruvian Hospital

  • Ludwig Caceres-Farfan;Wildor Samir Cubas;Franco Alban;Jorge Mantilla-Vasquez;Johny Mayta-Rodriguez;Karen Mendoza-Guerra
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.282-285
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    • 2023
  • Mature fetiform teratoma, or homunculus, is a term coined for a rare variant of teratoma with a prevalence of 0.01% of teratomas. There have been very few cases reported in the world, and its thoracic presentation is extremely unusual. We present the case of a 31-year-old female patient with a history of progressive chest pain in the left hemithorax, associated with dyspnea on moderate exertion and cough. Imaging studies revealed a large intrathoracic tumor visually compatible with a teratoma. Surgical resection by a clamshell approach was successful, and subsequent anatomopathological studies of the operative specimen concluded that the mass was a mature fetiform thoracic teratoma. The treatment of this entity is generally surgical and includes wide resection due to its large adhesive component to surrounding tissues. Thus, the cardiothoracic surgeon must know approaches that allow wide resection, making these cases true surgical challenges.

Valve-Sparing Neo-Aortic Root Replacement for Neo-Aortic Root Dilatation 20 Years after Arterial Switch Operation for Transposition of the Great Arteries: A Case Report

  • Sangjun Lee;Chan Hyeong Kim;Jae Hong Lee;Jae Gun Kwak
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.445-448
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    • 2023
  • A 25-year-old man returned to Seoul National University Children's Hospital with mild dyspnea on exertion. He had undergone an arterial switch operation at 1 month after birth to correct a complete transposition of the great arteries and a ventricular septal defect. When the patient was 15 years old, dilatation of the neo-aortic sinus and annulus was first identified; since then, it had gradually increased. Given the young age of the patient and the degree of aortic regurgitation (AR), which was mild to moderate, we opted to perform a valve-sparing neo-aortic root replacement with aortic valve repair. Postoperative echocardiography showed successful reductions in the sizes of the aortic sinus and annulus, with only mild AR remaining.

A Case of Primary Pulmonary Histiocytosis-X Associated with Central Diabetes Insipidus (중추성 요붕증을 동반한 원발성 폐 조직구종 X 1예)

  • Kim, Young-Min;Park, Yung-In;Choi, Young-Kuen;Lee, Jae-Seung;Lee, Woo-Chul;Hong, Jin-Hee;Lee, Soo-Bong;Reu, Ki-Chan;Lee, Min-Ki;Lee, Chang-Hun;Lee, Hyoung-Ryel;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.110-115
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    • 1999
  • Pulmonary histiocytosis X is a granulomatous disorder of the lung of unknown cause. Patients with this disease often complain of cough, dyspnea on exertion and, occasionally, chest pain from pneumothorax or bone involvement. However, DI is uncommon in these patients. We report a case of primary pulmonary histiocytosis X with central diabetes insipidus. A 23-year-old man presented with dyspnea suffered from dry cough, exertional dyspnea, polydipsia and polyuria for 4 months. He was a heavy smoker. He was found to have reticulonodular interstitial opacities on chest X-ray film. High-resolution computed tomography revealed thin-walled cysts of various sizes in both lungs. Open lung biopsy was done. On light microscopic examination revealed proliferation and infiltration of Langerhans cells. Immunohistochemically, Langerhans cells showed strong cytoplasmic staining with S-100 protein and electronmicroscopic examination showed Birbeck granules in Langerhans cells. Water deprivation test showed central-type diabetes insipidus and brain MRI showed no abnormal lesion on suprasellar region. Smoking cessation was recommended. He was treated with oral desmopressin.

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Surgical Correction of Partial Atrioventricular Canal: One Case Report (부분방실관의 교정수술 치험 1예)

  • 이철범
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.49-59
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    • 1981
  • This is one case report of surgically treated partial atrioventricular canal. The 22 year-old male patient had no definitive history of frequent respiratory infection and cyanosis in his early childhood. Since his age of 7 years, dyspnea was manifested on exertion. First appearance of congestive heart failure was at his age of 16 years old. The physical examination revealed that the neck veins were distended and heaving of precordium. A thrill was palpable on the left 3rd-4th intercostal space extending from the sternal border toward the apex and Grade IV/VI systolic ejection murmur was audible on it. Neither cyanosis nor clubbing was noted. Liver was palpable about 5 finger breadths. Chest X-ray revealed increased pulmonary vascularity and severe cardiomegaly (C-T ratio = 74%). EKG revealed LAD, clockwise rotation, LVH and trifascicular block. Echocardiogram showed paradoxical ventricular septal movement, narrowed left ventricular outflow tract and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted in large left to right shunt (Qp : Qs = 5.7: 1), ASD and moderate pulfllonary hypertension. Finally, left ventriculogram revealed typical goose neck appearance of left ventrlcalar outflow tract. On Oct. 10, 1980, open heart surgery was performed. Operative findings were: 1. Large primum defect ($6{\times}5$ Cm in diameter) 2. Cleft on the anterior leaflet of mitral valve. 3. The upper portion of ventricular septum was descent but no interventricular communication. 4. Downward attachment of the atrioventricular valves on the ventricular muscular septum. 5. Medium sized secumdum defect ($2{\times}1$ Cm in diameter). The cleft was repaired with 4 interrupted sutures. The primum defect was closed with Teflon patch and the secundum defect was closed with direct suture closure. Postoperatively atrial flutter-fibrillation in EKG and Grade U/VI apical systolic murmur were found. The postoperative course was uneventful and discharged on 29th postoperative day in good general conditions.

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