• Title/Summary/Keyword: 심장크기

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Surgical Treatment of Cardiac Myxoma: A 20 Years of Experiences (심장 점액종의 외과적 치료: 20년 임상경험)

  • Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Yie, Kil-Soo;Baek, Man-Jong;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.288-291
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    • 2007
  • Background: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment, Material and Method: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. Result: The mean age of the patients was $53.5{\pm}14.0$ years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases, The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: $84.0{\pm}71.3$ months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. Conclusion: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.

Analysis of Relativity Between Invasiveness on Chest of Tomographic Finding and Histopathologic Invasiveness (종격동 종양의 전산화 단층촬영(CT)소견, 수술소견 및 병리조직학적 침윤도 사이의 상관성 분석)

  • 김용희;이현우
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.780-785
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    • 1997
  • Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

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Evaluation and Comparison of Signal to Noise Ratio According to Change of Kernel size of Heart Shadow on Chest Image (흉부 영상에서 커넬 크기변화에 따르는 신호대잡음비 비교평가)

  • Lee, Eul-Kyu;Jeong, Hoi-Woun;Min, Jung-Whan
    • Journal of the Korean Society of Radiology
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    • v.11 no.6
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    • pp.443-451
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    • 2017
  • The purpose of this study was to comparison of measure signal to noise ratio (SNR) according to change of kernel size from region of interest (ROI) of heart shadow in chest image. We examined images of chest image of 100 patients in a University-affiliated hospital, Seoul, Korea. Chest images of each patient were calculated by using ImageJ. We have analysis socio-demographical variables, SNR according to images, 95% confidence according to SNR of difference in a mean of SNR. Differences of SNR among change of equalization were tested by SPSS Statistics21 ANOVA test for there was statistical significance 95%(p<0.05). In SNR results, with the quality of distributions in the order of kernel size 9*9 image, kernel size 7*7 image and original chest image, kernel size 3*3 image (p<0.001). In conclusion, this study would be that quantitative evaluation of heart shadow on chest image can be used as an adjunct to the kernel size chest image.

Two-Dimensional Echocardiographic Preoperative Prediction of Prosthetic Valve Size (이면성 심초음파도로 구한 대동맥판륜부 크기와 실제 치환된 판막크기와의 비교연구)

  • 정태은
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.979-983
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    • 1988
  • Calcium channel blockers may prevent myocardial injury during cardioplegia and reperfusion. This study was done to evaluate the effects of diltiazem cardioplegia on myocardial protection during ischemic arrest and recovery of myocardial function after reperfusion. Four formulations of crystalloid cardioplegic solutions, GIK solution[group I, n=12], diltiazem[lug/ml GIK] in GIK solution[group II, n=7], ],diltiazem[2ug/ml GIK] in GIK solution[group III, n=6] and diltiazem[4ug/ml GIK] in GIK solution[group IV, n=6] were compared in isolated working rat heart subjected to a long period [2 hours] of hypothermic arrest with multi-dose infusion. Diltiazem cardioplegia[group II, III and IV]was found to be superior in nearly all aspects. Diltiazem cardioplegia showed faster recovery of regular rhythm and lower incidence of ventricular fibrillation than group I did. In comparing mechanical function in all experimental hearts, the mean postischemic recoveries of aortic flow, cardiac output, peak aortic pressure, stroke volume and stroke work[expressed as a percentage of its preischemic control] were significantly greater in group II, III and IV[diltiazem cardioplegia] than in group I. The infused amount of cardioplegic solution was more increased by the addition of diltiazem to GI K solution. [p < 0.01] Creatine kinase leakage tended to be lower in hearts receiving diltiazem cardioplegia, especially in group III and IV[p<0.05] than in those receiving GIK solution only[group I]. Diltiazem cardioplegia results in the increased flow of cardioplegic solution and the decreased ischemic injury of myocardium during ischemic arrest and the improved recovery of myocardial function after reperfusion, and a dose-response relation must be established before clinical use.

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Isolated Right Ventricular Hypoplasia -A case report- (독립된 우심실 형성부전 - 1예 보고 -)

  • 이석기;서홍주;김웅한
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.683-686
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    • 2003
  • Isolated right ventricular hypoplasia is a rare clinical entity. We describe a case of right ventricular hypoplasia, single atrium and spongy myocardium of left ventricle. The volume of right ventricle was half the volume of left ventricle and z-value of tricuspid valve was -4 preoperatively The patient, 6-year-old boy, underwent atrial partitioning with 3 mm fenestration, Postoperative course was smooth and he tolerated the biventricular state well during follow-up. Follow-up catherterization was done 27 months later The tricuspid valve grew well (z-value= -0.4) and atrial septal fenestration is closed spontaneously. This article reports a case of successful biventricular repair in a patient with isolated right ventricular hypoplasia.

Real-time MCG Signal Processing System (실시간 심자도 신호처리 시스템)

  • Chung, D.H.;Lim, J.S.;Kim, P.K.;Ko, K.H.;Lee, D.H.;Kim, H.J.;Ahn, C.B.
    • Proceedings of the KIEE Conference
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    • 2004.07d
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    • pp.2685-2686
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    • 2004
  • 심자도(Magnetocardiography: MCG)는 심장에서 발생하는 자기신호로 크기가 수 pico Tesla에서 수 femto Tesla 정도로 지구 자기에 비하여 $10^{-6}{\sim}10^{-10}$ 정도로 매우 작기 때문에 보통 3층의 차폐 막 구조로 되어 있는 자기차폐실을 사용하여 외부 잡음을 줄인다. 그러나 자기차폐실의 비용이 크기 때문에, 자기차폐실의 비용을 줄이고 다양한 신호처리를 병행하여 신호대 잡음비를 높이고 있다. 본 논문에서는 1Giga FLOPS (FLoating point Operationals Per Second)의 부동 소숫점 연산능력을 가진 TMS320C6701을 사용하여 실시간 신호처리가 가능한 신호처리 시스템을 설계하였다. 개발된 DSP 보드는 PCI-bus 기반으로 설계하여 신호 측정 컴퓨터에 내장이 가능하도록 하였다. 프로그램과 데이터 처리를 위한 외부 메모리를 장착하였고, PCI 콘트롤러를 갖추어 PC 와의 대용량 메모리 공유가 가능하도록 하였다. 제작된 DSP 보드를 사용하여, 심자도 신호에서 실시간으로 적응 잡음 소거 및 필터링을 구현하여 신호대 잡음비의 향상을 확인할 수 있었다.

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Cavitating Adenocarcinoma and Soluamous Cell Carcinoma in the Same Lobe of the Lung (동일 폐엽내 발생한 공동화 선암과 펀평세포암)

  • 유지훈;김관민;김진국;심영목;한정호
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.153-156
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    • 2002
  • Synchronous primary lung cancers in the same lobe are rare. Cavitating adenocarcinoma as single lung lesion is unusual. We experienced cavitating adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. The patient was a 74-year-old male with chief complaints of hemoptysis. CT scan showd a central mass in right upper lobar bronchus, obstructive pneumonia, and lung abscess in the right upper lobe. Pathologically, the central mass was a 2.3$\times$1$\times$1 cm sized squamous cell carcinoma, and lung abscess was revealed as a 37272 cm sized adenocarcinoma. The patient was discharged without any specific problem after right peumonectomy.

A New Method of One Stage Correction of Taussig-Bing Anomaly with Interrupted Aortic Arch -1 case report- (대동맥궁 단절을 동반한 Taussig-Bing 기형에서 새로운 일차적 완전 교정술 - 1례 보고 -)

  • 정종필;서동만
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.83-87
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    • 1997
  • Taussig-Bing anomaly is infrequently associated with interrupted aortic arch and size discrepancy of great arteries makes it difficult to undergo arch reconstruction and arterial switch operation. A 20-day old male infant was admitted with the diagnosis of Taussig-Bing anomaly with type B Interrupted aortic arch. Multi-organ failure, due to the diminution of ductal flow, was stabilized after 3 weeks of prostaglandin El and controlled ventilatory support. The surgical correction consisted of VSD closure, arterial swtich and extended aortic arch reconstruction. The marked disparity between the hypoplastic ascending aorta and the dilated main pulmonary artery was overcome by constructing distal neoaorta using both native ascending and descending aortic tissue. The patient was extubated on postoperative 2nd day Postoperative catheterization showed no left ventricular outflow obstruction, no intracardiac shunt, and no incompetence of neoaortic valve.

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Multimodal Treatment of Pleuropulmonary Blastoma -Two case report- (흉막폐아세포종(Pleuropulmonary Blastoma) -치험 2예 보고-)

  • 박준석;한정호;구홍회;김진국
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.614-618
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    • 2003
  • Pleuropulmonary blastoma (PPB) is a rare intrathoracic neoplasm, found solely in childhood. The usual symptoms are dyspnea, chest discomfort, recurrent respiratory infections, fever, dry cough, and chest pain. The progress of PPB is usually aggressive and its progress is generally poor. Lymphatic spread to the hilar and mediastinal nodes can occur Distant metastasis is found in brain, bones, and intra-abdominal organs. Surgical resection is the treatment of choice. When the disease Is too extensive for surgical resection, neoadjuvant chemotherapy can be used. We report 2 cases of pleuropulrnonary blastoma in children successfully treated with multimodal therapy.

Thoracoscopic Surgery of Upper Esophageal Leiomyoma -One Case Report- (흉강경을 이용한 상부식도 펑활근종의 수술 치험 -1례 보고-)

  • 정진용;심성보
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.585-588
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    • 1996
  • We experienced a case of upper esophageal leiomyoma successfully excised by thoracoscopic surgery. A 29-year-old male was presented with retrosternal discomfort and mild dysphagia and an esophagogram revealed smooth fElling defect In the upper third of the intrathor cic esophagus, and esophagoscopy showed a submucosal tumor without mucosal infiltration. Chest CT and MRI were performed to confirm size, character and location of the esophageal mass, the absence of infiltration of surrounding structures, and to define mediastinal Iymphadenopathy. The tumor was excised by thoracoscopic surgery and it was diagnosed as leiomyoma (4$\times$2xlcm in size). The postoperative course was uneventful.

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