• Journal of Chest Surgery
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• 제41권4호
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• pp.496-498
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• 2008

심장 유두상 섬유탄력종은 원발성 종양 중 두 번째로 많이 호발하는 양성종양으로 주로 심장판막에 발생한다. 그러나 대부분 한곳에서 발생하며 다발성으로 발생하는 경우는 전체 심장 유두상 섬유탄력종의 5%로 아주 드문 경우이다. 55세 여자가 내원 10일전부터 발생한 순간적인 어지러움 및 실신으로 내원 시 검사한 심초음파상 대동맥 판막에 부착된 다발성 종양이 발견되어 수술 시행하였으며, 대동맥 판막의 손상 없이 대동맥 판막에 부착된 종양만 제거하였고, 환자 퇴원 후 외래 추적 관찰 중이다.

• Journal of Chest Surgery
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• 제39권9호
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• pp.729-732
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• 2006

외상에 의하여 심장눌림증을 유발한 종격동 양성낭기형종 종격동 기형종은 전체 종격동 종양의 $8\sim13%$ 빈도로 발생하며, 대부분 우연히 발견되지만 드물게 심낭 천공이 발생하여 심장눌림증을 유발하거나, 흉막삼출액을 고이게 한다. 본 증례에서는 전흉벽 타박상을 받은 여자 환자에게서 심장눌림증이 발생하였고, 응급 방사선검사에서 종격전부 종양이 확인되었으며 심장막천자술을 받은 후 활력징후가 회복되어 추후 수술적 절제술로 종양을 적출하였다. 조직검사에서 피지선, 성숙 지방종, 위장관점막, 호흡기도 점막 및 췌장의 조직 등으로 구성된 낭포성 구조물로 관찰되어 양성 낭기형종으로 판정되었다.

• Journal of Chest Surgery
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• 제56권3호
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• pp.186-193
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• 2023

Background: Complete surgical excision is the only curative treatment for primary cardiac tumors. For wide excision, interatrial septal reconstruction (ISR) is commonly performed. We hypothesized that ISR may increase the risk of postoperative atrial tachyarrhythmia (AT) after surgical resection of cardiac myxoma. Methods: After excluding patients with a history of cardiac surgery and concomitant procedures unrelated to tumor resection and those with AT or permanent pacemakers, we finally enrolled 272 adult patients who underwent benign cardiac tumor surgery from 1995 to 2021 at our institution. They were divided into the ISR (n=184) and non-ISR (n=88) groups. The primary outcome was postoperative new-onset AT. Results: The study cohort predominantly consisted of women (66.2%), with a mean age of 57.2±13.6 years. The incidence of postoperative new-onset AT was 15.4%. No 30-day mortality or recurrence was observed. The cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the ISR group than in the non-ISR group (p<0.001). The median duration of hospital stay of all patients was 6.0 days (interquartile range, 5.0-7.0 days), and no significant difference was observed between the 2 groups (p=0.329). ISR was not an independent predictor of new-onset AT (p=0.248). Male sex and hypertension were found to be independent predictors of new-onset AT. Conclusion: ISR was not a significant predictor of postoperative new-onset AT. ISR might be a feasible and safe procedure for surgical resection of cardiac myxoma and should be considered if needed.

• Journal of Chest Surgery
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• 제53권6호
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• pp.361-367
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• 2020

Background: Malignant primary cardiac tumors are extremely rare, but have a poor prognosis. This study evaluated the surgical outcomes of patients with this disease. Methods: Forty patients who underwent surgery for malignant primary cardiac tumors between January 1998 and December 2018 were enrolled. Participants were divided into 3 groups based on resection margins (R0, 14 patients; R1, 11 patients; and R2, 11 patients) and their surgical outcomes were compared. Heart transplantation was performed in 4 patients with unresectable tumors. Results: Early mortality was reported in 2 cases (5%) due to postoperative bleeding and cerebral hemorrhage secondary to brain metastasis. The 1- and 2-year survival rates were 67.5% and 42.5%, respectively. The median survival time of the patients was 20.3 months (range, 9.2-37.6 months). The median survival time was 48.7, 20.3, and 4.8 months in patients with R0, R1, and R2 resections, respectively (p=0.023). Tumor recurrence occurred in 21 patients (61.7%), including 4 cases of local recurrence and 17 cases of distant metastasis. In patients who underwent heart transplantation, the median survival time was 29.5 months, with 3 cases of distant metastasis. Conclusion: Although surgery for malignant primary cardiac tumors has a poor prognosis, complete resection of the tumor may improve surgical outcomes.

• Journal of Chest Surgery
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• 제37권3호
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• pp.228-234
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• 2004

원발성 심종양은 비특이적 증상을 호소하고 매우 드물게 발생하는 질환이다. 악성 종양과 양성 종양으로 구분되며 외과적 절제술과 부가적인 치료를 필요로 한다. 1995년 3월부터 2003년 3월까지 원발성 심종양으로 진단받은 21예의 환자들을 대상으로 하였다. 이 환자들을 대상으로 수술 전후의 여러 가지 인자들과 수술 후 조기 및 만기 성적에 대한 후향적 연구를 진행하였다. 6예는 남자, 15예는 여자였으며 그들의 평균 연령은 45.44$\pm$18.76세였다. 병리학적 검사 결과 21예 중에서 18예는 양성(14예의 점액종, 2예의 섬유탄력종, 1예의 혈관종, 1예의 부신경절종), 3예는 악성(1예의 혈관 육종, 1예의 중피종, 1예 점액섬유육종)종양이었다. 1예의 수술 사망이 관찰되었고, 혈관종, 중피종과 혈관육종의 경우 근치적인 수술이 불가능한 상태에서 술 후 부가적인 치료와 외래 추적 중에 사망하였다. 원발성 심종양의 치료에 있어서 수술적 치료가 중요하며 경우에 따라서 부가적인 치료도 중요하지만 악성의 결과 예후는 불량하다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1269-1272
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• 1992

Benign cardiac tumors are almost uniformly curable, but malignant cardiac tumors are almost always fatal despite of modern techniques of diagnosis and surgical treatment Resection of malignant tumors of heart is occasionally feasible and can result in prolonged survival, although cure is unlikely. Survival may be enhanced by postoperative irradiation in selected patients, but chemotherapy does not appear to be beneficial. Fibromyxosarocoma of the left atrium is a primary malignant tumor of the heart which is extremely rare and has a poor prognosis and rapid recurrence. It is important to differentiate the uniformly fatal fibromyxosarcoma from the more common benign atrial myxoma. A 19-year-old woman with a fibromyxosarcoma of the left atrium which was extirpated surgically, and postoperative irradiation was given[totally 4,500 rads]. She is still alive 9 months postoperatively without recurrence.

• Journal of Chest Surgery
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• 제31권7호
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• pp.735-738
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• 1998

심장내의 혈관종은 매우 드문 질환으로써 부검 예가 아닌 경우로는 전세계적으로 37예만이 보고되어있다. 증상은 종양의 위치에 따라 우심실 유출로 폐쇄에 따른 증상이나 상공정맥 혹은 하공정맥을 막아서 생기는 등의 다양한 증상이 나타날 수 있으며 때로는 증상이 없이 발견되기도 한다. 치료는 수술 적인 절제를 원칙으로 하나 보고된 예가 적은 관계로 예후에 대해서는 잘 알려져 있지 않다. 그러나 조직학적으로는 양성에 속한다. 연세대학교 심장혈관센터에서는, 흉부 둔상을 주소로 내원한 40세 남자 환자에서 심장 초음파 검사결과 우연히 심장내의 종괴를 발견하였다. 종괴는 수술을 시행하여 절제하였으며 조직학적 검사상 양성 혈관종으로 판명되었다. 환자는 수술후 합병증이 없이 퇴원하였으며 수술후 1년간 관찰 추적중인데, 현재까지 재발없이 양호한 상태를 보이고 있다.

• The Korean Journal of Physiology and Pharmacology
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• 제23권5호
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• pp.393-402
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• 2019

Aurora kinases inhibitors, including ZM447439 (ZM), which suppress cell division, have attracted a great deal of attention as potential novel anti-cancer drugs. Several recent studies have confirmed the anti-cancer effects of ZM in various cancer cell lines. However, there have been no studies regarding the cardiac safety of this agent. We performed several cytotoxicity, invasion and migration assays to examine the anti-cancer effects of ZM. To evaluate the potential effects of ZM on cardiac repolarisation, whole-cell patch-clamp experiments were performed with human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) and cells with heterogeneous cardiac ion channel expression. We also conducted a contractility assay with rat ventricular myocytes to determine the effects of ZM on myocardial contraction and/or relaxation. In tests to determine in vitro efficacy, ZM inhibited the proliferation of A549, H1299 (lung cancer), MCF-7 (breast cancer) and HepG2 (hepatoma) cell lines with $IC_{50}$ in the submicromolar range, and attenuated the invasive and metastatic capacity of A549 cells. In cardiac toxicity testing, ZM did not significantly affect $I_{Na}$, $I_{Ks}$ or $I_{K1}$, but decreased $I_{hERG}$ in a dose-dependent manner ($IC_{50}$: $6.53{\mu}M$). In action potential (AP) assay using hiPSC-CMs, ZM did not induce any changes in AP parameters up to $3{\mu}M$, but it at $10{\mu}M$ induced prolongation of AP duration. In summary, ZM showed potent broad-spectrum anti-tumor activity, but relatively low levels of cardiac side effects compared to the effective doses to tumor. Therefore, ZM has a potential to be a candidate as an anti-cancer with low cardiac toxicity.

• Journal of Chest Surgery
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• 제21권3호
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• pp.518-525
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• 1988

Between 1977 and 1987, 8 patients underwent excision of cardiac myxomas at the Hanyang University Hospital. All had a left atrial myxoma. There were 4 female and 4 male patients ranging from 15 to 62 years of age. Preoperative findings consist of symptoms and signs of congestive heart failure except one. Diagnosis was confirmed by echocardiography[8 cases] and angiography[2 cases], preoperatively. A biatrial operative approach was utilized in all but 2, who were small sized. Complete excision of the tumor with a cuff of normal tissue[1 was atrial wall and 7 were atrial septum] was performed. all heart chambers were carefully explored for presence of multicentric myxomas or tumor debris. There were no operative deaths or intraoperative embolization. Follow-up has been 1/3 to 10 years. There has been 1 late death, due to recurrence and 1 patient had reoperation for mitral regurgitation due to dilatation of the annulus by a huge tumor mass. Surgical excision of the myxoma can be performed with low morbidity, and it provides excellent and sustained symptomatic relief. The recurrence rate is low, but long-term follow-up and serial echocardiography are advisable.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10267-10272
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• 2015

To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (p<0.05) and TNM staging (p<0.05). Correlation analysis showed that CA24-2 was significantly correlated with CA19-9 (r=0.810, p<0.001). The levels of CEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.