• Journal of Chest Surgery
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• v.17 no.1
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• pp.32-40
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• 1984

During the past six years from July 1977 to June 1983, fifteen adult patients of patent ductus arteriosus were surgically treated. The results were as follows: 1. Of the 15 patients, their age range was 17 to 34 years with a mean of 24 years, and sexual predominance was women [9. cf. 6 men]. 2. The most common symptom showed exertional dyspnea, and 10 patients were classed in NYHA class II, the rest were all class III. 3. On physical examination, all patients were auscultated continuous murmur, but concomitantly diastolic murmur was noted apical region in 2 patients. 4. On roentgenogram of chest, normal finding was 3 patients, and the other patients were revealed the evidence of pulmonary congestion. 5. The electrocardiogram was normal in 6 patients, but LVH was seen in 5, and 2 patients were LVH+ LAH. 6. Cardiac catheterization was performed in 12, and mean value of SO2[LPA-RV] was 6.3%, Q/Q 2.09, peak systolic pulmonary arterial pressure 45.3 mmHg, and Rp/Rs 0.365. 7. All operations were carried out by posterolateral thoracotomy. In 6 patients, division and suture of ductus were possible, the other patients were treated by division and ligation with heavy silk or Dacron patch. 8. Postoperative complications were hoarseness, persistent murmur, reoperation for bleeding, and atelectasis. Early and late mortality was 20% [3 patients], and cause of death was mainly aneurysmal rupture of previous operative site.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.291-293
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• 2015

Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large intracranial aneurysm of the ACoA. A 41-year-old woman was admitted to our neurosurgical department with a sudden-onset bursting headache and visual impairment. On admission, her vision was decreased to finger counting at 30 cm in the left eye and 50 cm in the right eye, and a severe bitemporal hemianopsia was demonstrated on visual field testing. A brain computed tomography scan revealed a subarachnoid hemorrhage at the basal cistern, and conventional cerebral catheter angiography of the left internal carotid artery demonstrated an $18{\times}8mm$ dumbbell-shaped aneurysm at the ACoA. Microscopic aneurysmal clipping was performed. An ACoA aneurysm can produce visual field defects by compressing the optic chiasm or nerves. We emphasize that it is important to diagnose an aneurysm through cerebrovascular study to prevent confusing it with pituitary apoplexy.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.355-359
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• 1993

Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

• Journal of Chest Surgery
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• v.45 no.1
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• pp.49-52
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• 2012

A coronary-bronchial artery fistula is a very rare congenital anomaly of the coronary artery whose etiology and pathogenesis have not yet been clarified. Most patients with coronary-bronchial fistulas are asymptomatic; however, some patients present with congestive heart failure, infective endocarditis, myocardial ischemia induced by a coronary steal phenomenon, or rupture of an aneurysmal fistula. Furthermore, patients with a coronary-bronchial artery fistula rarely manifest life-threatening hemoptysis due to the associated bronchiectasis. We report herein the case of a patient with a coronary-bronchial artery fistula who had bronchiectasis and a history of massive hemoptysis and myocardial ischemia.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.1
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• pp.35-42
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• 2003

PAP (Palatal Augmentation Prosthesis) may be given to the patients with dysphagia; especially, who cannot achieve tongue-palate contact. PAP fills hard palate area where the tongue cannot make contact and then the distance of tongue elevation is shortened. 1bat may be expected to improve swallowing and to prevent from aspiration. The purpose of this report is to show the effects of PAP in patients with dysphagia through the videofluoroscopic study. Oral-pharyngeal swallowing post PAP is analyzed in 2 cases; one is a person who had subarachnoid hemorrhage due to aneurysmal rupture, right hemiparesis, hydrocephalus and aphamia. And the other is a person who had squamous cell carcinoma on mouth floor and he had radical neck dissection and marginal mandibulectomy. In this report, the rate of aspiration, the transit time and length measurements of anatomical structure are examined in the each frame of videofluoroscopy. The results are as follows; 1) PAP decreased the aspiration in both cases. 2) In the cases of patients with PAP, the pharyngeal transit time was decreased.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.791-798
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• 1990

Takayasu’s disease produces the occlusive and aneurysmal lesions of major branches of the aorta. Angiography is the most important diagnostic procedure in Takayasu’s disease. Surgical treatment is often justified to avoid the possible lethal consequences of hypertension on the heart, kidney, and brain, as well as in the case of aneurysm because of its risk of rupture. We experienced one case of the Takayasu’s disease associated with abdominal coarctation and renovascular hypertension. The patient was 17 years old female and had suffered from hypertension for 14 months. On physical examination, BP was 150/100 mmHg in the right arm and 120/80 mmHg in the left arm. The pulses of the left brachial and femoral arteries were weakly palpable. Aortogram showed the stenosis of the left common and subclavian arteries, coarctation of the abdominal aorta, and stenosis of the right renal artery and complete occlusion of the left renal artery. The stenosis of the right renal artery and the occlusion of the left renal artery produced the renovascular hypertension. She underwent aorta-aortic bypass for the coarctation of the abdominal aorta and aorta-renal bypass for treatment of renovascular hypertension Postoperatively, both femoral pulses were equally palpable. On discharge, antihypertensive drugs were discontinued. She has remained normotensive for last one year.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.178-181
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• 2008

Although endovascular intervention is the first-line treatment of intracranial aneurysm, intraprocedural rupture or extravasation is still an endangering event. We describe two interesting cases of extravasation during embolotherapy for ruptured peripheral cerebral pseudoaneurysms. Two male patients were admitted after development of sudden headache with presentation of intracerebral and subarachnoid hemorrhage, respectively. Initial angiographic assessment failed to uncover any aneurysmal dilatation in both patients. Two weeks afterwards, catheter angiography revealed aneurysms each in the peripheral middle cerebral artery and anterior inferior cerebellar artery. Under a general anesthesia, endovascular embolization was attempted without systemic heparinization. In each case, sudden extravasation was noted around the aneurysm during manual injection of contrast after microcatheter navigation. Immediate computed tomographic scan showed a large amount of contrast collection within the brain, but they tolerated and made an unremarkable recovery thereafter. Intraprocedural extravasation is an endangering event and needs prompt management, however proximal plugging with coil deployment can be sufficient alternative, if one confronts with peripheral pseudoaneurysm. Peculiar angiographic features are deemed attributable to extremely fragile, porous vascular wall of the pseudoaneurysm. Accordingly, it should be noted that extreme caution being needed to handle such a friable vascular lesion.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1482-1486
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• 1992

Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Eight patients underwent operative treatment at Chonnam University Hospital from June, 1986 to May, 1992. Six of the patients were male and two female. Age ranged from eight to fifty six years. Associated cardiac lesions were common including AR and VSD in four patients respectively. Diagnosis was made by 2D-Echo and cine-angiogram. In six patients aneurysms of the sinus of valsalva ruptured from the right coronary sinus to the right ventricle and in two from right coronary sinus to the right atrium Direct closure of aneurysmal rupture and patch closure of VSD in four cases, resection of the aneurysm and direct closure in one case, direct closure of the fistula and AVR in two cases, direct closure in one case were performed. One patient combined with VSD, pulmonary hypertention and bacterial endocarditis underwent operation, but he died of sudden cardiac arrest the day after the operation. Operative results were relatively good in the other patients.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.528-531
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• 2010

Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue fragility. The authors report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery. Transfemoral cerebral angiography (TFCA) was done to verify the aneurysmal dilatation. However, during TFCA, bleeding at the puncture site was not controlled, skin and underlying muscle was disrupted and profound bleeding occurred during manual compression after femoral catheter removal. Accordingly, surgical repair of the injured femoral artery was performed. At this time it was possible to diagnose it as an EDS with fusiform aneurysm on cervical vertebral artery. Particularly, cervical fusiform aneurysm is rare condition, and therefore, connective tissue disorder must be considered in such cases. If connective tissue disorder is suspected, the authors suggest that a noninvasive imaging modality, such as, high quality computed tomography angiography, be used to evaluate the vascular lesion to avoid potential arterial complications.

• Journal of Sasang Constitutional Medicine
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• v.14 no.2
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• pp.106-114
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• 2002

The etiology of spontaneous intracerebral hematoma is aneurysmal rupture, arteriovenous malfomation, brain rumor, blood dyscrasia, cerebral infaction, cerebra inflammatory vascular disease, hypertension, and unknown causes. And the primary intracerebral hematoma is caused by unknown causes including hypertension. The clinical diagnosis of intracerebral hematoma, size, location, ventricular penetration, and evolution of brain parenchyme by hemorrhage are confirmed by CT scan. The authors have experienced 1 case of spontaneous intracerebral hematoma confirmed by CT scan. We have diagnosed the patient as Soyangin and treated by east integrated therapy. We classified this case as Soyangin-liyoiljung(少陽人裏熱證) and prescribed Yangkyuksanhwatang' Jihwangbaekhotang Hyungbangsabaeksan to the principle of Cheongyangsangsung(淸陽上升). In the result, we had the improvement of the symptoms. This report discribed the process and contents about the way the patient was cured.