• Journal of Chest Surgery
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• v.24 no.1
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• pp.1-7
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• 1991

This report describes our 10-year experience with intracardiac repair in 42 patients older than 16 year with tetralogy of Fallot. The mean age was 22.0$\pm$5.18 years[range 16~41]. The preoperative clinical manifestations were cyanosis & clubbing[93%], frequent URI [55%], anoxic spell[40%], pulmonary tuberculosis[21%], tuberculous empyema[7%], chronic renal failure[7%], congestive heart failure[7%] and subacute bacterial endocarditis [2%], etc. The previous shunt procedure for palliation had been performed in 7 patients. The type of VSD were typical perimembranous type[67%], total canal defect[28%] and combined type[5%]. The right ventricular outflow tract obstruction were combined type[69%], infundibular type[21%] and valvular type[10%]. Transannular patch was used in 50% of patients. Associated cardiovascular anomalies were ASD[33%], PFO[31%], Rt. aortic arch[10%], Lt. SVC[10%], single Rt. pulmonary artery, single Lt. coronary artery, ASI, proximal stenosis of Rt. pulmonary artery and anomalous systemic venous return, etc. Hospital mortality was 7.1%[3 cases]in overall. The causes of hospital deaths were revealed low cardiac output & acute renal failure[2 cases], postoperative bleeding[1 case]. There were 2 late deaths 3 & 68 months after surgery. Residual intracardiac shunt was detected in 2 patients. one patient was successfully reoperated and another patient had Qp /Qs ratio less than 1.5.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.422-427
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• 1982

A clinical analysis of 82 cases who were sustained the penetrating gun-shot wound in the chest by 8 bullets was done during 4~ year-period from January 1978 to August 1982 in the department of thoracic surgery, CA FGH. Among 82 cases, 61 cases [74.4%] of them were brought to the Hospital by ambulance, 21 cases [25.6%] were by Helicopter and 76 cases [92.7%] of them were admitted within 4 hours after wounding. Thirty eight [46.3%] patients were treated by closed thoracotomy only, 19 cases [23.2%]by open thoracotomy, 18 cases [22.0%] by primary closure with debridement, and 7 cases [8.5%] by vascular surgery. Causes of open thoracotomy were due to massive intrapleural bleeding in 16 cases, rupture of diaphragm in 2 Gases, and heart injury in one case. Among 25 cases of surgical complications, wound infection was most common in 16 cases [53.5%] and recurrent pneumothorax in 3 cases [10%], empyema in 3 cases [10%], and BPF in one case [3.3%]. Hospital mortality was seen in 6 cases due to hypovolemic shock and respiratory insufficiency in 4 cases, spinal shock in 2 cases due to spinal injury.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.166-171
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• 2010

Background: Controlled hypotension is used to reduce bleeding and improve surgical conditions during surgery. Nicardipine and remifentanil have been used to induce controlled hypotension in healthy patients. This study compared controllability of nicardipine and remifentanil on hemodynamic stability during controlled hypotension. Methods: Forty healthy patients scheduled for orthognathic two jaw surgery were randomly allocated to nicardipine (group N) and remifentanil (group R) group. After induction of anesthesia, group N (n = 20) was infused with nicardipine to induce hypotension and group R (n = 20) was infused with remifentanil. Mean arterial pressure (MAP) and heart rate (HR) were measured over 5 minute interval. Surgical field rating and blood loss were measured after surgery. Results: HR was lower in group R than group N. MAP was maintained at 50-60 mmHg during controlled hypotension but the fluctuation of blood pressure and HR were more frequent in group N than group R. There were no significant differences in the surgical field rating and blood loss between the groups. Conclusions: Nicardipine and remifentanil enabled controlled hypotension and provided good surgical conditions, but the fluctuation of hemodynamic parameters was more frequent in nicardipine group.

• The Korea Journal of Herbology
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• v.27 no.5
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• pp.77-83
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• 2012

Objective : For the purpose of developing Korean herbalogy of the plants to Violaceae in Korea, the literatures of the successive generations have been thoroughly investigated to prepare this article. Methods : The examined herbalogical books and research paper which published at home and abroad. Results : 1. Violaceae plants (raised in Korea) are devided into 1 classes with 57 species. Among them, 14 species in 1 classes were found serviceable, which indicates 32 % of all Violaceae plants. 2. The herb is main medicinal part if medicinal plants in the Violaceae, which is used in 14 species. 3. According to the nature and flavor of medicinal plants in the Violaceae, they were classified into cold 8 species, and cool 7; bitter taste 8; acrid taste and little bitter taste 6 in the order. 4. According to the meridian propism of medicinal plants in the Violaceae, they were classified into liver meridian 6 species, heart meridian 3 species in the order. 5. According to the properties and principal curative action, they were classified into drugs for clearing heat, removing toxins 12 species; drugs for alleviate edema 7, and drugs for arresting bleeding 6 in the order. 6. There were no toxic species in the Violaceae family. Conclusion : There were totaled to 1 genera and 57 species in Violaceae in Korea and among them medicinal plants are 1genera, 14 species, some 32% in total.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.664-668
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• 1994

A total of 217 patients underwent single mitral valve replacement [MVR] with the St. Jude Medical valve between September 1984 and the end of 1992. There were 86 males and 131 females with a mean age of 34.6 $\pm$ 14.4 years[range 5 months-61 years]. A previous valve replacement had been performed in 46 patients [21.2 %]. An early mortality rate was 7.4 % [5.2 % in primary MVR; and 15.2 %in re-replacement MVR]. Early survivors of 201 patients were followed up for a total of 934.5 patient-years[mean 4.7 $\pm$ 2.1years]. A late mortality rate was 2.5 % or 0.54%/patient-year. The linearized rates of thromboembolism, valve thrombosis and anticoagulation-related bleeding were 1.301 %, 0.214 % and 0.428 %/patient-year, respectively. The actuarial survival including operative mortality was 89.9 % $\pm$ 2.1% at postoperative 10 years. The freedom from thromboemolism was 91.3 %$\pm$ 2.5% and the actuarial estimate of incidence free from late deaths and all complications were 80.9 % $\pm$ 3.8 % at 10 years. There were no mechanical failures. In summary, the St. Jude Medical prosthesis performed satisfactorily with an acceptable rate of late complications.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1377-1380
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• 1996

Severe hemodynamic dysfunction may follow after the closure of the median sternotomy in patients with myocardial edema, cardiac dilatation, and severe postoperative bleeding. In extreme cases, myocardial edema may be so severe that cardiac function is compromised merely by the edges of the open sternum touching the heart. Sternotomy remained open and delayed sternal closure is already described adjunct in complicated cardiac operations. We experi nced a case of delayed sternal closure after 16 hours of CABG using synthes DCP wide plate in a 54-year old obese female patient. Our experience conims that delayed sternal closure Is an effective at simple means of dealing with severe myocardial edema so we report this case with literature review.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.475-478
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• 2002

A 45 year old man was admitted for aggravated dyspnea, abdominal distension and poor oral intake. On Echocardiogram, mitral stenosis(severe), tricuspid regurgitaion(IV), and LA thrombus were diagnosed. We used heparin with continuous infusion for prevention of systemic thrombo embolism. On the 11th day of admission, the patient showed thrombocytopenia and we suspected Heparin-induced thrombocytopenia. Hirudin was used in this case as alternative anticoagulant during cardiopulmonary bypass to prevent serious complication of heparin. The patient was recovered without any complication as postoperative bleeding or systemic thromboembolism.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.253-257
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• 2023

A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1003-1009
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• 2004

Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.241-249
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• 1977

Atrial septal defect is one of the most frequently encountered congenital heart disease. Up to December 31, 1976, 1682 cardiac patients received cardiac catheterization in the cardiac department of Yonsei university medical college. Out of the 1682 cardiac patients 723 cases had congenital heart disease and only 116 cases had congetial atrial septal defect. This amounted to 16.04% of all those with congenital heart disease. 58 cases of congenital atrial septal defect operated in the chest surgery department were presented. Of these 58 cases of atrial septal defect, 27 cases were male and 31 cases were female. Their ages ranged from 5 years to 54 years. The systolic pressure of the main pulmonary artery of 40 out of the 58 cases of atrial septal defect was below 40% of that of the systemic blood pressure: in 6 cases, the range of the systolic pressure of the main pulmonary artery was 50-90mmHg; in 12 cases, the range of the systolic pressure of the main pulmonary artery was 40-50mmHg. Average age of these was 30. 1 years. This study tends to show that Korean patients with atrial septal defect even though younger have a slight higher systolic pressure of the main pulmonary artery than Western patients have. The pulmonary blood is 1.5-2.5 times of systemic blood flow in 52 cases out of 58 cases of atrial septal defect.In only one of the 58 cases of atrial septal defect, the Rp was found to be as high as 45% of Rs. All other cases were below this level.51 cases had ostium secundum defect, 4 out of these cases had ostium secundum defect combined with mitral incompetence and 6 out of them had double ostium secundum defect. The remaining 7 cases had ostium primum defect. Their atrial defects were repaired under direct vision utilizing extracorporeal circulation, by hemodilution technic combined with moderate hypothermia. 44 cases [2nd atrial septal defect] were repaired by direct sutures while 14 cases, including the 7 cases ostium primum defects needed patches [1 pericardium and 13 teflon patch]. In 4 cases there were single defects while showed two defects. However the associated septal defect was so small that it could be closed by direct sutures. The size of the defect ranged between 6.0cm2and 10.0cm2 in 19 cases[33.7%]: the smallest being 0. 5cm2 and the largest 24cm2. The surgical mortality was 2 cases [3.4%]. These one case with ostium primum defect, could not be resuscitated on operation table. The cause of death in this case was myocardial failure and MI. The other, a case of ostium primum defect had a second operation on the first operative day due to massive bleeding from LV vent-line insertion site.The patient died on 26th post-operative day due to sepsis.