• Journal of Chest Surgery
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• v.19 no.4
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• pp.688-694
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• 1986

Takayasu`s disease is an arteritis of unknown etiology involving larger elastic arteries such as aorta and its branches, pulmonary arteries and rarely coronary arteries. Especially, aortic root involvement with the valvular leaflets has been reported in several cases of Takayasu`s arteritis. Recently we have experienced one case of Takayasu`s arteritis involving left subclavian artery, descending aorta, left renal artery and multiple valvular leaflets. The patient was 33 year-old female and admitted with complaints of cough, dyspnea and general weakness. Aortogram revealed extensive type of arteritis showing dilatation of ascending aorta, segmental narrowing of thoracic aorta and Riolan`s anastomosis. Double valve replacement [mitral and aortic valve] and tricuspid valve annuloplasty were performed. The patient made an excellent postoperative recovery and has shown striking improvement in cardiac status, NYHA functional class II eight months after operation.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1084-1087
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• 1989

Subannular aortic aneurysm is a word-wide rare disease entity occurring predominantly in young black men. In Korea, there has been no report. We report one patient, 46 years old man, who had been operated urgently because of acute aortic insufficiency and aortic valvular vegetation after antibiotics treatment of Subacute bacterial endocarditis for 6wks. At the operative field, We found the bulging aneurysmal mass between the aorta and superior vena cava above the right pulmonary artery, which has subannular communicating opening into the left ventricular cavity, beneath the anterior commissure of the bicuspid aortic valve. Pathologic findings are consistent with "portion of vascular wall with features of aneurysm.* The patients survived aortic valve replacement and patch closure of subannular aneurysm, with no symptoms at one-year postoperative follow-up.w-up.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.801-803
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• 1993

Surgical correction of patent ductus arteriosus is,under most circumstances,highly successful and carries a low mortality. But infected PDA is yet potentially dangerous due to its frequent recurrence and resistant organisms to antibiotics. And,in surgical correction,surgeon may face the possibility of tearing of ductus arteriosus arterial end due to friability and adhesion of its surrounding tissue.This report demonstrats another problem in treatment of infected patent ductus arteriosus.This thirteen years old female patient received susceptible combined antibiotics intravenously from the day of admission and remitted from 4th.week of therapy.This remission state continued for 12days without relapse.But the pulmonary artery ruptured in this remission period.In autopsy,bacteria was not found in ductal vegetation.Also,there was no pulmonary artery aneurysm,Our experience show that in infected PDA,pulmonary artery can rupture spontaneously during remission period without aneurysmal formation.

• Journal of Chest Surgery
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• v.14 no.2
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• pp.175-178
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• 1981

Since the first report by Freeman of renal artery repair for renovascular hypertension in 1954, there has been a gradual improvement in the results of renovascular reconstruction. This is case report of renovascular hypertension due to diffuse primary arteritis, which was performed aorto-bllateral renal bypass graft with using of Y -woven dacron graft. This 33 y-o male has complained intermittent headache, facial edema & malignent hypertension symptoms for 1.5 years. He had the history of Rt. B-K amputation due to unhealed wound after trauma of the Rt. great toe about 7 years ago. The abdominal aortography revealed nearly not visualized the Rt. renal artery & severe narrowing of the Lt. renal arterly. During postop. course, Blood pressure was well controlled. At postop. 3rd week, systolic pressure was down to 130-140mmHg But, diastolic pressure was remained to 100-110mmHg. At postop. 30th day, exploration was done due to intestinal obstruction signs. But severe ischemic enteritis was occured due to fibrotic obstruction of the superior mesenteric artery. The next day, he was dead. in spite of Rt. common iliac artery-sup. mesenteric artery bypass graft.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.489-493
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• 1986

Takayasu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries such as aorta and its branches, pulmonary arteries, and rarely coronary arteries. The late pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. the disease occurs predominantly in females, with the age of onset between 10 and 30 years. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch and all its major branches. The patient was 36 year-old female and she was admitted because of headache, blurred vision, and easy fatigability and motor weakness of upper extremities. Aortogram revealed total obstruction of both carotid arteries at the site of its origin and partial irregular obstructive change in the innominate artery and both subclavian arteries. Bypass graft surgery using Gore-Tex grafts was performed with successful result.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.979-986
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• 1991

From October 1988 to November 1989, seven patients underwent valve replacement during the active phase of native valve endocarditis. There were 4 males and 3 females whose mean age was 41 years[range, 16 to 68 years]. Preoperative two-dimensional and Doppler echocardiography showed vegetations and severe valvular regurgitation in all patients. Blood cultures were positive in 4, and negative in 3 patients Organisms were alpha-hemolytic Streptococcus in 2, Staphylococcus epidermidis in 1, Erysipelothrix rhusiopathiae in 1 patient Valve tissue cultures were negative in all patients. Intravenous antibiotic therapy had been done for 3 to 18 days in 5 patients pre-operatively and was not done in 2 patients, Indications for operation were heart failure in h, and systemic emboli in 1 patient. The aortic valve was involved in 3, mitral in 1, and both aortic and mitral in 3 patients, One operative death[14.4%] occurred in patient with cardiogenic shock before operation. Late death occurred in one on 14 months after operation. The remaining 5 patients were followed up over a two year period in good condition. In conclusion, native valve endocarditis with severe heart failure must be considered for early operation.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.25-28
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• 1972

Patent ductus arteriosus is one of the most common congenital heart diseases, which treated operatively has excellent results. Treatment by surgical means is common and invariably successful. However,infected PDA cases present problems and surgeons operating must face the possibility of adhesions,aneurysmal dilatation and friabiilty of tissue with tearing of the pulmonary arterial end, especially, which causes a fatal hemorrhagic ccmplication. In the earlier days of cardiac surgery, many surgeons deferred operative treatment infected PDA because of frequent complications, high postoperative morbidity and mortality. This continued until Touroff et al. successfully divided the infected PDA in 1940. In 1944, Harper et aI. have used Cellophane for the wrapping of the infected PDA. This surgical procedure has become a single, simple and safe method for treating infected PDA, since that time. In the Teflon wrapping technique, a cardiothoracic team of Yonsei University Severance Hospital used Teflon felt instead of Cellophane in one case of infected PDA and this method proved intractable to antibiotic treatment for 40 days.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.121-130
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• 1988

During one year period from Sep. 1986 to Sep. 1987, we have experienced 6 cases of infective endocarditis requiring surgical interventions. All 6 patients had class IV or V cardiac disability at the time of surgery. The indication for surgery was rapidly progressive congestive heart failure in all cases. Four patients underwent aortic valve replacement including one double valve replacement. Two other patients required other surgical procedures, removal of large left atrial vegetation mass in one patient and excision of destroyed pulmonary valve and aortic vegetation in the other patient. Two patients died; one of mitral annulus rupture after release of aortic clamp and the other of mediastinal bleeding 3 months after replacement of aortic valve. Three out of 4 survivors are in NYHA Class I and the remaining patient is in Class II. We emphasize that early operative intervention is life-saving in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.394-398
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• 1994

Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and it`s major branches. We experienced two surgical cases of Takayasu`s arteritis associated with the stenosis of the descending thoracic aorta. One case was 15 year-old girl and she was admitted because of dyspnea on exertion for 12 months. Aortogram showed the stenosis of the descending thoracic aorta from just below left subclavian artery to the 9th thoracic vetebra. The other case was 10 year-old girl and she was admitted because of URI and hypertension. Aortogram showed narrowing of right innominate artery, but developed collateral circulation, and the stenosis of the descending thoracic aorta near the 9th thoracic vertebra. In each case, bypass graft from the ascending aorta to the abdominal aorta just above the inferior mesenteric artery was performed with satisfactory result.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.995-997
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• 2000

내장의 통증은 교감신경을 통하여 척수로 전달된다고 알려져있다. 특히 췌장염이나 췌장암의 통증에 관해서 Mallet-Guy 등이 1943년 큰내장신경 및 요교감신경절 절제술을 시행한 이래로 상기 방법이 이용되어 왔다. 내장신경 절제술은 효과에 비해 수술이 커지고, 긴 바늘을 이용한 복강신경총 차단술이 발달하면서 사장된 방법으로 여겨졌다. 그러나, 최근에 흉강경을 이용한 수술방법이 발달하면서 간단히 큰내장신경 절제술이 가능해져 흉강경을 이용한 큰내장신경 절단술은 난치성 복통치료의 좋은 방법으로 받아 들여지고 있다.