• Journal of Chest Surgery
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• v.20 no.2
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• pp.317-322
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• 1987

Records of 15 patients who underwent operation for constrictive pericarditis at this department from 1976 through 1984 were reviewed. All had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. There were 12 males and 3 females in this series. Range of age varied from 7 years to 51 years. Clinical and histological study revealed granulomatous pericarditis compatible with the diagnosis of tuberculosis in 5 patients, non-specific chronic inflammatory changes in 6 patients and pyogenic pericarditis in 2 patients. Pericardiectomy was performed through a median sternotomy [11 cases] or bilateral anterior thoracotomy [4 cases]. The postoperative complications were observed in 4 patients. Low cardiac output was the most common complication [2 patients]. In 13 cases, excluding 2 operative deaths, preoperatively all were in New York Heart Association Class III or IV. At the time of discharge II [85%] were in Class I or II. 4 Cases were reoperated after original pericardiostomy and all resulted in marked improvement. Early surgical intervention is advisable in all patients in whom cardiac constriction is caused by either a thickened pericardium or a pericardial effusion before myocardial dysfunction occurs.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.112-115
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• 2016

Noonan syndrome is an autosomal dominant, multisystem disorder. Autoimmune thyroiditis with hypothyroidism is an infrequent feature in patients with Noonan syndrome. A 16-year-old boy was admitted because of chest discomfort and dyspnea; an echocardiogram revealed pericardial effusion. Additional investigations led to a diagnosis of severe hypothyroidism due to Hashimoto thyroiditis. The patient was treated with L-thyroxine at 0.15 mg daily. However, during admission, he developed symptoms of cardiac tamponade. Closed pericardiostomy was performed, after which the patient's chest discomfort improved, and his vital signs stabilized. Herein, we report a case of an adolescent with Noonan syndrome, who was diagnosed with Hashimoto thyroiditis with an unusual presentation of cardiac tamponade.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.661-668
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• 1997

The majority of lung cancers associated with hyperamylasemia are adenocarcinomas. Here we report an unusual case of a 54-year-old male patient who complained of dyspnea, anterior chest wall discomfort and facial edema for one month, presenting with a huge mediastinal mass and hyperamylasemia complicated by pericardial effusion. Histological evaluation of mediastinal mass revealed small cell carcinoma and pericardium showed nonspecific inflammation with fibrosis. The serum amylase had an electrophoretic mobility similar to that of salivary gland enzyme. There were no evidence of a salivary or pancreatic causes of hyperamylasemia. After chemotherapy, parenchymal lung lesions improved and hyperamylasemia disappeared. For the management of pericardial effusion, a pericardial window was formed. We concluded that the striking increase in serum amylase was due to the ectopic production of this enzyme by the tumor.

• The Korean Journal of Cytopathology
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• v.8 no.1
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• pp.35-46
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• 1997

The authors reviewed 167 malignant effusions from 110 patients, of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm. Main factors analysed were the distribution of primary organs and the cytohistoiogic correlation of body cavity effusions. The 167 fluid specimens from 110 patients consisted of 90 cases(53.9%) of pleural, 68(40.7%) of peritoneal, and 9(5.4%) of pericardial origins. Histologically they consisted of 82 cases(74.5%) of adenocarcinoma, 8(7.3%) of malignant lymphoma, 6(5.5%) of squamous ceil carcinoma, and 3(2.7%) of small cell carcinoma. The most common site among the primary lesions was the stomach in 25 cases(22.7%) followed by the lung in 21(19.1%), ovary on 17(15.5%), and breast in 7(6.4%). As for the distribution of primary tumors in adenocarcinoma, the most common site was lung un 16 cases (48.5%) in pleural fluid and stomach in 22(48.9%) in peritoneal fluid. In pericardial effusions, all 5 cases were from the lung. As a whole, the cytologic findings of malignant effusion were fairly representative of histologic characteristics of primary lesions. Thus, when the primary lesion Is unknown, careful evaluation of effusion cytology is presumed to be a helpful tooi for tracing the primary tumor.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1354-1359
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• 1996

Few observation have been made on the pericardial pressure and little is known about the composition of he pericardial fluid. So we studied the basic qualitative and quantitative analysis of the pericardial fluid in the patients with cardiac disease either congenital heart diasese(group A) or acquired heart disease(group B). The pressure of the pericardial cavity was measured by the method of open tipped water filled small polyethylene catheter connecting to the standardized monitor, which was introduced into pericardium of the patients who were performed pericardial incision for the heart or pericardial surgery. All of the data was compared to the simultaneously checked hematologic value of the same patient. The mean pressure of the pericardial cavity was 2.4mmHg and the amount of the pericardial fluid was 13cc/m2 of body surface for the group A and 17.7cc for the group B. And the cell count was 138$\pm$l16/1 in group A and 230$\pm$135/1 in group B and the pH was 7.83$\pm$0.40 in group A. 7.80$\pm$0.52 in group B. Pericardial fluid revealed satisfactically significant alkaline pH than plasma. The fundamental electrolyte, Wa+, K+, Cl and glucose were identical to the hematologic values of the same patient, but the protein concentration was 2.Bg/dL for group A and 3.Ig/dL for group B heart disease and those were remarkable low concentration compared to the hematologic value of the same patient. LDH and amylase were identical to the value of the serum of the same patient, but the concentration of LDH of group B was slightly higher than that of the group A.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.812-816
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• 2002

Pericardial effusions result from various conditions such as inflammation, malignancies, open heart surgery and uremia. Recently, video assisted thoracic surgery (VATS) has been used for diagnostic and therapeutic purposes in the management of pericardial effusion and intrathoracic lesions due to its ability to provide outstanding visibility of intrathoracic structures with less pain, superior cosmetic effects, and shorter hospital stay Material and Method: From April 1995 to October 2001, 51 patients received pericardial window operation via either thoracoscopic(Group A, n＝37, m:f＝18:19, mean age＝56.4 yrs)or thoracotomy approach(Group B, n＝14, m:f＝8:6, mean age=58.4 yrs). Result: In group A, the operation time, duration of chest tube insertion, recurrence rate of pericardial effusion, and postoperative hospital stay were 61.2 minutes, 9.3 days, 2.7%, 16.2 days, respectively while in group B these values were 58.4 minutes, 12.2 days, 7.1, and 17.3 days. The number of injections for pain control in group A were 4.2 times, whereas in group B it was 6.3 times. Although there was a tendency for the mean hospital stay and duration of chest tube insertion to be shorter in group A than in group B, these differences did not reach statistical significance. There was also no significant difference in the operation time and recurrence rate between the two groups. Conclusion: The safety and effectiveness of VATS in the management of pericardial effusion is comparable to the open thoracotomy method. It allows for a shorter hospital stay, duration of chest tube insertion, lesser postoperative pain and a smaller skin incision.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.247-249
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• 2011

We report a case of pseudo-pseudoaneurysm, which is a very rare complication of myocardial infarction. A 69-year-old man was admitted to our clinic with chest tightness and dyspnea. He had undergone aortic valve replacement with a pericardial bioprosthetic valve, ring mitral annuloplasty, and reconstruction of an aortic annular defect due to infective endocarditis with bovine pericardium 4 years prior. Echocardiography and computed tomography showed pericardial effusion and a 16-mm cavity at the anterolateral wall of the left ventricle. Magnetic resonance imaging suggested either pseudo-pseudoaneurysm or myocardial abscess. We successfully repaired the myocardial defect using a patch made from a vascular graft with pledgeted horizontal mattress sutures under cardiopulmonary bypass.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.197-203
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• 2024

Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.265-271
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• 1999

Patients with mediastinal teratoma are usually asymptomatic, but may develop symptoms by rupture into adjacent structures which result in pneumonia, hemoptysis, pleural effusion, pericardial effusion, or pneumothorax. Rarely, life-threatening acute respiratory distress require a emergency surgery. Rupture into pleural cavity may result in pleuritis and pleural effusion with severe anterior chest or back pain. The symptom must be differentiated from other common intrathoracic distress diseases. Clinical, cytologic and radiologic examinations of pleural effusion, and moreover, measurement of enzymes such as amylase or insulin, which is secreted from pancreatic tissues, in pleural effusion and cystic fluid enabled us to make the diagnosis of rupture of mediastinal teratoma preoperatively.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.426-432
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• 2013

Background: Heart transplantation has become a widely accepted surgical option for end-stage heart failure in Korea since its first success in 1992. We reviewed early postoperative complications and mortality in 239 patients who underwent heart transplantation using bicaval technique in Asan Medical Center. Methods: Between January 1999 and December 2011, a total of 247 patients aged over 17 received heart transplantation using bicaval technique in Asan Medical Center. After excluding four patients with concomitant kidney transplantation and four with heart-lung transplantation, 239 patients were enrolled in this study. We evaluated their early postoperative complications and mortality. Postoperative complications included primary graft failure, cerebrovascular accident, mediastinal bleeding, renal failure, low cardiac output syndrome requiring intra-aortic balloon pump or extracorporeal membrane oxygenation insertion, pericardial effusion, and inguinal lymphocele. Follow-up was 100% complete with a mean follow-up duration of $58.4{\pm}43.6$ months. Results: Early death occurred in three patients (1.3%). The most common complications were pericardial effusion (61.5%) followed by arrhythmia (41.8%) and mediastinal bleeding (8.4%). Among the patients complicated with pericardial effusion, only 13 (5.4%) required window operation. The incidence of other significant complications was less than 5%: stroke (1.3%), low cardiac output syndrome (2.5%), renal failure requiring renal replacement (3.8%), sternal wound infection (2.0%), and inguinal lymphocele (4.6%). Most of complications did not result in the extended length of hospital stay except mediastinal bleeding (p=0.034). Conclusion: Heart transplantation is a widely accepted option of surgical treatment for end-stage heart failure with good early outcomes and relatively low catastrophic complications.