• Title/Summary/Keyword: 심장CT

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The Study on Electrocardiographic Changes after Mitral Valvular Replacement (승모판막 수술에 따른 심전도 변화)

  • Yeo, Seung-Dong;Im, Seung-Pyeong
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.421-427
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    • 1991
  • Atrial fibrillation[Af] is closely related to thrombus in left atrium, systemic embolism, and loss of the contribution of atrial contraction to cardiac output. Therefore maintenance of sinus rhythm[SR] is undoubtedly hemodynamically superior to Af in the clinical course of mitral valvular disease especially in the unstable period immediately after surgery. In this article, the conversion rate and the factors influencing the conversion of Af to SR after surgery were studied. Ninety-three patients with mitral valvular replacement at Chungnam National University Hospital were analysed with electrocardiography before and after surgery during the period from June 1985 to June 1990. Eighty patients presented Af before surgery. Twenty-four[30Yo] of the patients were converted to SR[A group] and fifty six presented continuous Af after surgery[B group]. The duration of preoperative Af, preoperative left atrial dimension[LAD], preoperative functional status[NYHA classification] and cardiothoracic[CT] ratio were factors influencing the conversion of Af to SR after surgery. The mean preoperative duration of Af was 3.5$\pm$2.6yr in group A and 7.6$\pm$4.9yr in group B. The mean preoperative LAD was 53. 7$\pm$9.4mm in group A and 62.5$\pm$11.2mm in group B. Before surgery, eleven patients[46%] were belong to NYHA class I, II in group A and eight[14%] in group B. The preoperative CT ratio was 62$\pm$6% in group A and 69$\pm$8% in group B.

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Pulmonary Thromboendanterectomy of Chronic Pulmonary Thromboembol ism -A case Report- (만성 폐색전증의 색전제거술 -치험 1례 보고-)

  • 신윤철;지현근
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.569-572
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    • 1996
  • A sixty nine-year-old mate patient was admitted with a chief complaint of exertional dyspnea. Lung perfusion scan revealed total perfusion defect of the of left lung and CT anglography showed the ab- rupt cutoff left pulmonary artery. He denied of trauma history, previous lower leg symptom and sign, or any embolic history. With the impression of chronic pulmonary thromboembolism of unknown etiology, operation was done under the cardiopulmonary bypass through a median sternotomy. After main pulmonary artery clamping and pulmonary arteriotomy, thromboembolectomy was done. Postoperative lung perfusion scan and CT angiography showed near normal left pulmonary blood flow. The patient was discharged on the postoperative 9th day without any postoperative complication.

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Surgical Extent for Ground Glass Nodules

  • Cho, Suk Ki
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.338-341
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    • 2021
  • As diagnoses of small ground glass nodule (GGN)-type lung adenocarcinoma are increasing due to the increasing frequency of computed tomography (CT) screening, surgical treatment for GGN-type lung adenocarcinoma has rapidly become more common. However, the appropriate surgical extent for these lesions remains unclear; therefore, several retrospective studies have been published and prospectively randomized controlled trials are being undertaken. This article takes a closer look at each clinical study. Convincing evidence must be published on 2 issues for sublobar resection to be accepted as a standard surgical option for GGN lung adenocarcinoma. In the absence of such evidence, it is better to perform lobar resection as long as the patient has sufficient lung function. The first issue is the definition of a sufficient resection margin, and the second is whether lymph node metastasis is conclusively ruled out before surgery. An additional issue is the need for an accurate calculation of the total size and solid size on CT. Given the results of clinical studies so far, wedge resection or segmentectomy shows a good prognosis for GGNs with a total size of 2 cm or less. Therefore, sublobar resection will play a key role even in patients who can tolerate lobectomy.

Pneumocystis Pneumonia Developing during Treatment of Recurrent Renal Cell Cancer with Nivolumab (니볼루맙 치료 도중 발생한 폐포자충 폐렴 1예)

  • Kim, Hak Ro;Keam, Bhumsuk;Park, Young Sik;Kim, Miso;Kim, Tae Min;Kim, Dong-Wan;Heo, Dae Seog
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.571-574
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    • 2018
  • Nivolumab is an immune checkpoint inhibitor approved for the treatment of metastatic cancers. Here, we report the case of a 65-year-old male with recurrent renal cell carcinoma. After six cycles of nivolumab treatment, positron emission tomography/computed tomography (PET/CT) was performed to evaluate the response. PET/CT revealed diffuse ground glass opacities in both lungs. He developed a cough, sputum, chills, and a febrile sense. After bronchoscopic bronchoalveolar lavage, pneumocystis pneumonia was finally diagnosed.

Valve-Sparing Root Replacement in a Turner Syndrome Patient with Bicuspid Aortic Valve and Juxtacommissural Origin of the Right Coronary Artery: A Case Report

  • Son, Dong Hyeon;Cho, Sungkyu;Song, Mi Kyoung
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.413-416
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    • 2022
  • A 32-year-old woman diagnosed with Turner syndrome presented to the hospital for an evaluation of cardiovascular complications. Preoperative computed tomography (CT) and echocardiography showed progression of aortic root and ascending aorta dilatation, as well as a bicuspid aortic valve. There was no evidence of aortic regurgitation. We planned valve-sparing aortic root replacement and ascending aorta replacement with a high risk of aortic rupture. Intraoperatively, we incidentally found a juxtacommissural origin of the right coronary artery (RCA). We performed aortic valve reimplantation using a graft designed with a key-shaped hole to wrap the juxtacommissural-origin RCA by modifying the Florida sleeve technique. Coronary blood flow was patent on postoperative CT angiography, and there was no evidence of aortic regurgitation on postoperative echocardiography. The patient was discharged from the hospital on postoperative day 7 without any complications.

Usability Evaluation of Lateral Sliding Table in CT Examination (CT 검사에서 Lateral Sliding Table의 유용성 평가)

  • Choi, Jeong Hun;Kong, Chang gi;Song, Jong Nam;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.677-684
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    • 2020
  • Miscentering in the left and right X axis direction during CT examination affects dose and quality. When the CT Gantry Isocenter and the center of the examination objective are matched using the Lateral Sliding Table, the image quality is improved and the exposure dose is reduced. CTDI Head Phantom (Kimda, Korea) and dosimeter (Ray Safe, Sweden) were used to measure dose comparison CTDI (mGy) due to center deviation, and Water Phantom (HITACHI, Japan) was used to measure noise to see the difference in uniformity due to center deviation. Measurements of doses for dose comparison CTDI (mGy) with a deviation showed that doses were consistently reduced and exact dose was not projected until they were moved to 80 mm by 20 mm from the Isocenter. SD values were measured to see the difference in uniformity due to center deviation and the noise continued to increase until it was moved by 20 mm to 80 mm. The range of collimation has increased by the extent of deviating from the center and the range of exposure has increased. Using the Lateral Sliding Table, you can easily adjust the Isocenter, increase the quality of the image by adjusting the Isocenter in areaa such as the cardiac examination of the location away from the Isocenter, Extreme bone and Shoulder, and greatly reduce the collimation to the Isocenter, so it can be used to reduce unnecessary exposure dose.

Assessment of Allograft Function in Dog Single Lung Transplantation on CT (한국산 잡견에서 컴퓨터단층촬영을 이용한 이식폐의 기능평가)

  • 박기성;박창권
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1055-1061
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    • 1997
  • In the field of the experimental lung transplantation, we analyzed the CT findings of acute rejection, infection in the left single allotransplanted lung of adult mongrel dogs, and the CT findings were compared with the histological findings obtained by the lung biopsy Twenty two adult mongrel dogs were divided into two groups(Donor and recipient group). Donor lungs were flushed with LPDG(low pota,ilium dextral glucose) solution(n=4) or modified Euro-collins solution(n=7) and preserved over 20 hours with $10^{\circ}C(1$ case preservation for 4hours). After left single lung transplantation, the chest X-ray and sequential computed tomogram were performed with concomitant hemodynamic study and arterial blood gas analysis on immediate postoperative period, postoperative 3rd day and postoperative 7th day. Two of eleven transplanted lungs had acute rejection which was represented as moderate infiltration at immediate or 1st postoperative d y but became extensive infiltration at postoperative 3rd day on CT. There were showed one case of bronchopleural fistula, six cases of pneumonia and two cases of pulmonary infarction. In one rejection cases, the opacity of transplanted lung was improved by injection of methylprednisolone 500mg daily during 3 days. We concluded that CT was a useful noninvasive evaluation parameter after lung transplantation and the serial CT scan enabled early detection of acute rejection.

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Acute Extrapericardial Tamponade by Hemomediastinum by Sternal Fracture -Two case report- (흉골 골절로 발생한 종격동혈종에 의한 급성 심낭외 압전 -2예 보고 -)

  • Hur, Jin;Goo, Bon-Won;Lee, Jin-Woong;Kim, Hyo-Yoon
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.211-214
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    • 2003
  • Sternal fracture is relatively common in chest trauma. Mediastinal hematoma secondary to sternal fracture is not in common, and it has minor symptoms such as mild dyspnea and chest tightness, which usually resolve spontaneously. We experienced two cases of extrapericardial tamponade by hematoma caused by sternal fractures. Two patients were diagnosed by chest CT scan and sent to the operating room within 2 hours after arriving at emergency room because of unstable vital signs. Cardiovascular signs were relieved immediatly after the operation. We report these cases with a brief review of the literature.

Anomalous systemic arterial supply to lung without sequestration in an infant who has congenital heart disease : a case report (선천성 심장질환을 가진 영아에서 발견된 폐 격리증을 동반하지 않은 폐의 이상 체 동맥 기시 1례)

  • Jang, Yeon Woo;Choi, Duck Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.895-897
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    • 2006
  • Systemic arterial supply from the aorta to the lung is a rare congenital anomaly within the spectrum of bronchopulmonary sequestration according to Pryce's terminology. We describe our experience of this anomaly in an infant with congenital cardiac disease confirmed by multidetector CT scan. We found a systemic arterial supply from the aorta to the right lower lobe of lung without right lower lobar pulmonary artery and bronchopulmonary sequestration. This combination of congenital anomaly is most rare form.

A Case Report of Tension Pneumopericardium Following Blunt Chest Trauma (흉부둔상에 의한 긴장성 심막기종 1예 체험)

  • Sohn, Sang-Tae;Kim, Eung-Soo;Kang, Jong-Yeol;Song, Dong-Seop
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.803-806
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    • 2009
  • A 49-year-old man visited our hospital via the emergency room. He had suffered chest trauma by falling down. His chest X-Ray showed pneumomediastinum with pneumopericardium. We checked the Chest CT, and it showed pneumopericardium without any injury to the other organs, the compressed heart and a minimal pneumothorax on the left hemithorax. Closed thoracostomy was then done under local anesthesia. We then performed open pericardiostomy under general anesthesia. We got a good result and so we report on this case.