• Journal of Chest Surgery
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• v.35 no.10
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• pp.705-711
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• 2002

The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.

• Journal of the Korean Society of Radiology
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• v.12 no.5
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• pp.669-675
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• 2018

This study aimed to investigate the difference of X-ray exposure by comparing and analyzing entrance surface dose and absorbed dose according to the frame change in coronary angiography using an X-ray machine. Moreover, appropriate frame selection measures for examination, including the effect of frame change on the image quality, were sought by measuring and analyzing the SNR and CNR of the image through image J. The study was conducted on 30 patients (19 males and 11 females) who underwent CAG at this hospital from June 2017 to October 2017. In regard to the patients, their age range was 49-82 years (mean of $65{\pm}9$ years), body weight was 45-91 kg (mean of $67{\pm}8.9kg$), height was 150-179cm (mean of $165.1{\pm}8.9kg$), and BMI was 19.5-30.5(mean of $24.5{\pm}2.9$). For the entrance surface dose and absorbed dose, air kerma value and DAP were obtained and analyzed retrospectively. The SNR and CNR were measured and analyzed through imageJ, and the result values were derived by applying the values to the formula. As for the statistical analyses, the correlations between the entrance surface dose and absorbed dose, and between the SNR and CNR were analyzed by using the SPSS statistical program. The relationship between the entrance surface dose and absorbed dose was not statistically significant for both 10 f/s and 15 f/s (p>0.05). In terms of the relationship between the SNR and CNR, the SNR ($3.374{\pm}2.1297$) and CNR ($0.234{\pm}0.2249$) in 10 f/s were $1.43{\pm}0.4861$ and $0.132{\pm}0.0555$ lower, respectively, than the SNR ($4.929{\pm}2.8532$) and CNR ($0.391{\pm}0.3025$) in 15 f/s, which were not statistically significant (p>0.05). In the correlation analysis, statistically significant results were obtained among the BMI, air kerma, and DAP; between air kerma and DAP; and between SNR and CNR (p<0.001, p<0.001). In conclusion, there was no significant difference between the entrance surface dose and absorbed dose even when the images were taken by changing the frame from 10 f/s to 15 f/s at the time of the coronary angiography. SNR and CNR increased at 15 f/s than at 10 f/s, but they were not statistically significant. Therefore, this study suggests that the concern of the patient and practitioner regarding image quality degradation, as well as the problem of X-ray exposure caused by imaging at 10 f/s and 15 f/s, may be reduced.

• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.225-232
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• 2004

Purpose : Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Materials and Methods : Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV election fraction (LVEF) was $\geq5%$ lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1 %(non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Results : Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs. 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs. 9.2%, p=0.029; severity 13.5 vs. 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis ($80{\sim}99%$) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Conclusion : Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than patients without post-stress LV dysfunction. All of the patients without perfusion defect in stunning group had significant coronary artery stenosis and needed revascularization. Therefore, we suggest that invasive diagnostic procedures and therapeutic interventions might be needed in patients with post-stress LV dysfunction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.56-59
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• 2003

The incident of false aneurysm of internal maxillary artery in the oral and maxillofacial region is known to be very rare. One case of false aneurysm in the internal maxillary artery is presented, which was experienced in our department. The etiology of this case is regarded as the mandibular condyle fracture, and/or iatrogenic trauma during open reduction. Clinically, there were systolic bruit on auscultation, pulsation and massive bleeding during operation. The lesion was finally diagnosed with angiography and treated by embolization procedure. False aneurysm can cause so massive bleeding as to threat the life of the patients. Therefore accurate diagnosis and treatment is very important. Angiography enables the solid diagnosis for the clinical one. And as the embolization has many advantages over the ligation, it can be a good treatment method.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.659-665
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• 2003

The aim of this study was to evaluate the early and midterm results of off-pump total arterial revascularization using the skeletonized right gastroepiploic artery (RGEA) as a third arterial conduit. Material and Method: We prospectively analyzed 103 patients who underwent off-pump total arterial revascularization using bilateral internal thoracic arteries (ITAS) and RGEA. The RGEA was used as in situ graft in 88 patients, composite graft in 10 patients, and free graft in 5 patients. Postoperative coronary angiographies were performed before discharge in 100 patients, and at postoperative one year in 88 patients. Result: The RGEA showed a significantly higher free flow (130$\pm$95 ml/min) than that of right ITA(113$\pm$57 ml/min) or left ITA (107$\pm$55 ml/min), which was measured before anastomosis (p < 0.05). The total number of distal anastomoses was 3.8$\pm$0.7. The number of distal anastomoses per bilateral ITAs was 2.8$\pm$0.7 and the number of distal anastomosis per RGEA was 1.0. There were two morialities including one operative mortality. The late mortality was not related to cardiac events. Early postoperative morbidities were atrial fibrillation in 15 patients, bleeding reoperation in 4 patients, mediastinitis in 1 patients, perioperative myocardial infarction in 2 patient, and transient ARF in 3 patients. Postoperative coronary angiographies showed the early patency rate of 98.6％ (272/276) for ITAs and 97.0％ (97/100) for RGEA, respectively (p=ns), and the one-year patency rate of 95.9％ (234/244) for ITAs and 88.6％ (78/88) for RGEA, respectively (p=0.07). Flow competition between the RGEA and NCA (native coronary artery) was seen in 5 of the 100 patients (5.0％) immediate postoperatively and 7 of the 88 patients (8.0％) 1 year after surgery. Since July, 2000, we measured transit time flow intraoperatively and could reduce flow competition significantly Conclusion: The skeletonized RGEA demonstrated excellent early and midterm patency rates and could be used as a third arterial graft following the bilateral ITAs.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.97-102
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• 2004

Anomalous systemic arterial supply to the lung is a rare congenital anomaly. The lung supplied by the anomalus systemic artery has a normal bronchial tree, which is usually in the basal segment of the lung, especially in the left lung. Most of patients are asymptomatic, but the main clinical symptoms of this disease are hemoptysis and exertional dyspnea. CT is useful for the diagnosis and showed a retrocardiac nodular shadow connected to the descending aorta branching into the basal segments of the relatively normal lower lobe. Surgery is indicated for all patients. Here we report a case of anomalous systemic arterial supply to normal basal segments of left lower lobe in a patient with hemoptysis with a review of the relevant literature.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.139-145
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• 2005

Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.241-244
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• 2005

A 57-year-old man with numbness and paresthesia of left arm is presented. There was no pulse in the left arm was absent and his chest radiograph suggested right-sided aortic arch. The aortogram showed right-sided aortic arch with Kommerell's diverticulum. The proximal portion of left subclavian artery was totally occluded and blood was being supplied through vertebral arteries to distal subclavian artery. He underwent bypass grafting between both subclavian arteries by an expanded polytetrafluoroethylene graft. Because the size of Kommerell's diverticulum was small, it need to be observed closely.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.324-328
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• 1998

Esophageal hemangioma is an extremely rare benign tumor that causes dysphagia and massive upper gastrointestinal bleeding. Although certain abnormalities seen on a barium swallow esophagography or at endoscopy may suggest an esophageal hemangioma, a contrast CT and radionuclide angiography using a blood-pool radiopharmaceutical can characterize the intense vascularity of the tumor. We experienced the ase of a 7$\times$7$\times$3.5 cm in size giant cavernous hemangioma of the lower 1/3 of esophagus in a 40 year old man. A mural cavernous hemangioma was diagnosed with a barium swallowed esophagogaphy, endoscopy, and a contrast CT. It was treated successfully by transthoracic esophagectomy including the tumor and esophagogastrostomy.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.275-278
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• 2009

Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor. Yet tumors of a smooth muscle origin are the most common primary neoplasms of the major veins, and the inferior vena cava is the most common site of origin. We report here on a 65-year-old female patient who had been suffering from dyspnea and abdominal discomfort for 3 weeks before admission. The abdominal computed tomography (CT) scan and IVC cavogram showed an IVC mass extending from the right atrium to above the level of the right renal vein, obstructing the IVC, and the radiological findings were suggestive of an IVC leiomyosarcoma. We resected the tumor and reconstructed the IVC with a patch PTFE graft. The follow-up abdominal CT revealed no recurrence and obstruction of the IVC for 6 months after the operation.