• Title/Summary/Keyword: 혈관염

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Annular Constrictive Pericarditis: Simulating Vavular Heart Disease : Case Report (윤상 교약성 심낭염의 외과적 치료 -2예 보고-)

  • 유회성
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.280-284
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    • 1980
  • This is report of two cases of annular constrictive pericarditis. Since January 1959 to December 1979 the authors experienced 48 cases of chronic constrictive pericarditis treated surgically at the Department of Thoracic and Cardiovascular Surgery, the National Medical Center in Seoul. These cases simulated valvular heart disease. One case, as mitral stenosis, revealed rumbling apical diastolic murmur [II/VI], atrial fibrillation and right ventricular hypertrophy pattern on E.C.G., the other, as infundibular pulmonic stenosis, presented pressure gradient between right ventricle and main pulmonary artery at infundibular level of 76 mmHg in systole. Both patients underwent operation successfully and one of them was assisted by E.C.C. during pericardiectomy and result was excellent. It is difficult to make the diagnosis of these conditions preoperatively so consideration about these might be important to make the diagnosis accurately.

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Irrigation-suction System for Management of Deep Sternal Wound Infection after Open Heart Surgery -Four cases- (개심술 후 발생한 심부 흉골 창상감염의 세척-흡입법을 이용한 치험 -4예 보고-)

  • 김상익;오상준
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.431-435
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    • 2003
  • Deep sternal wound infection (with or without acute mediastinitis) is a serious complication of open heart surgery, with high rates of associated morbidity and mortality, and prolonged hospitallization. The result of treatment largely depends on timely diagnosis and appropriate surgical management. Postoperative deep sternal wound infections in 4 cases were successfully treated with extensive debridement, pressurized jet irrigation with antibiotic solution, sternal refixation by Robicsek method, and dilute antibiotic irrigation via irrigation-suction system. We report 4 cases with review of articles.

Infective Endocarditis of Aortic Valve and Tricuspid Valve Associated with a Fistula between Aorta and Right Ventricle - One Case Report - (대동맥과 우심실사이의 누루를 동반한 대동맥판막 및 삼첨판막의 감염성 심내막염 치험 1례)

  • Seo, Pil-Won;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.889-893
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    • 1988
  • We experienced a case of infective endocarditis of aortic valve and tricuspid valve associated with a fistula between aorta and right ventricle. The patient was 35 years old woman and showed severe congestive heart failure. Large and multiple vagetations were found on the valvular surfaces and a fistula was present between aorta and right ventricle. Probably infective endocarditis of aortic valve resulted in annular abscess and as it healed, a fistula was formed and tricuspid valve endocarditis followed. We replaced the aortic valve and tricuspid valve with St. Jude mechanical prostheses, and closed the fistula opening with suture. The postoperative course was smooth and the patient has no problems till now 4 months after operation.

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Surgical Treatment of Chronic Constrictive Pericarditis -Report of 4 ases- (만성 교약성 심낭염의 외과적 치료 -4례 보고-)

  • 전희재
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.793-797
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    • 1994
  • Constrictive pericarditis is often accompanied with ~brothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective symptoms. We experienced 4 cases of constrictive pericarditis combined with bilateral ~brothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time through anterolateral thoracotomy with sternal transection[3 patients] and median sternotomy incision[l patient]. Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive retraction for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right atrium, SVC and IVC.

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Surgical Treatment of Acute Active Endocarditis (급성 활동성 심내막염의 수술적 치료)

  • 김성호
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.759-763
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    • 1994
  • Between November 1990 and December 1993, 9 patients underwent surgical intervention for acute active endocarditis at Gyeongsang National University Hospital. All the patients were operated on within the first six weeks after onset of symptoms for various reasons. Surgical indications for early surgery were heart failure, systemic septic emboli, new murmur and growing vegetation. Most common infecting organism was Staphylococcus[55 %], and the others were Streptococcus, anaerobes, Candida and unknown in 1 case. The infection was in the mitral valve in 5 patients, the aortic valve in 2, the aortic and mitral in 1, and the aortic and pulmonary in 1. There was one operative death[11 %] and no late death. Preoperative Functional Class were II in 4 patients, III in 5 and after surgery all the patients improved to Class I. We conclude that early surgical intervention in acute active endocarditis is effective in most instances.

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The Usefulness of Harmonic Scalpel During Pericardiectomy for Constrictive Pericariditis (교착성 심막염에 대한 심막절제술시의 Harmonic Scalpel의 유용성)

  • 김도형;이정철;정태은;한승세;이장훈;이동협
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.605-607
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    • 2002
  • Harmonic Scalpel(Ethicon Endo-Surgery, Cincinnati, OH) has many advantages including no muscular stimulation, low heat, less smoke, easy hemostasis using ultrasound and good operation field. In patient with constrictive pericarditis, Harmonic Scalpel was beneficial during pericardiectomy.

Bronchogenic Squamous Cell Carcinoma in Patient with Swyer-James Syndrome -One Case Report (Swyer-James (MacLeod) 증후군에 병발한 기관지원성 편평 상피세포암 1예)

  • 김경화;서연호;구자홍;김민호
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.784-788
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    • 2003
  • Swyer-James syndrome is a rare disease with patients presenting with unilateral hyperlucent lungs and hypoperfusion due to hypoplasia of the pulmonary artery and bronchiolitis obliterans. A unilateral hyperlucent lung generally develops after a lower respiratory tract infection during early childhood. In extremely rare cases, an association of bronchogenic carcinoma with Swyer-James syndrome has been reported. We report a case of bronchogenic squamous cell carcinoma associated with Swyer-James syndrome that performed right upper lobectomy and lymph node dissection with a relevant literature review.

Mediastinitis Caused by Prevotella Intermedia/Nigrescens Occurred after Acupuncture -A case report- (침술후 발생한 Prevotella intermedia/nigrescens에 의한 종격동염 -치험1례-)

  • 김수성;하경임
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.440-444
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    • 2000
  • A 54-year-old male patient was admitted due to dyspnea with chest pain and reddish swelling in the right lteral neck and right upper which developed 2 or 3 days age. He was treated with acupuncture in the neck about one week ago prior to admission. CT scans of the chest showed density of air and abnormal soft tissue which suggested abscess of the anterior mediastinum and subcutaneous tissue. He underwent cervical and mediastinal drainage with closed thoracostomy and antibiotic therapy. Black-pigmente anaerobic nonspore-forming gram-negative bacilli were isolated from the mediastinal pus and were identified as Prevotella intermedia/nigrescens upon performing biochemical tests and API rapid ID 32A (bioMeriux, France) kit. He underwent decortication of the right side because of loculated empyema on 41st postoperative day. He was fully recovered and discharged on the 82nd hospital day. This was thought to be another case of descending necrotizing mediastinitis not caused by peritonsilar abscess but by cellulitis developed after acupuncture. Early deterction of mediastinits and aggressive drainage of mediastinal abscess are important.

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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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Surgical Treatment of Takayasu`s Arteritis with Renovascular Hypertension (신성고혈압을 동반한 Takayasu 동맥염의 수술치험 1)

  • 권우석
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.171-176
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    • 1987
  • Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and its major branches. Symptoms and signs of the disease are various depending on the involved area. We experienced a surgical case of Takayasu`s arteritis mainly involving both renal arteries with renovascular hypertension in a 13 year old girl. Hypertension was not controlled by medical treatment including diuretics and captopril [160/140 mmHg]. Aortogram showed severely stenosed right renal artery, nearly obstructed left renal artery and not visulalized superior mesenteric artery. Angioplasty was performed for the right renal artery but aorta-renal bypass graft with greater saphenous vein was inevitable for the left renal artery. Blood pressure was controlled sufficiently with some adjunct of captopril postoperatively [130/90 mmHg]. While the patient was discharged with much improvement, she was lost follow up and died of not identified definitive cause 3 months later.

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