• Journal of Chest Surgery
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• 제24권10호
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• pp.973-978
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• 1991

From January, 1982, to December, 1990, 15 patients underwent pericardiectomy for chronic constrictive pericarditis on Department Of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University. There were 9 male and 6 female patients [male to female ratio was 1.5: 1] ranging from 15 years to 63 years old [mean age 35.0]. All patients underwent pericardiectomy through a median sternotomy, partial cardiopulmonary bypass was performed on two patients. There were 3 postoperative death [20%]. Six cases [40%] were tuberculous origin 5 cases [34%] were Idiopathic [nonspecific chronic inflammatory change was considered to idiopathic], 2 cases [13%] were malignant origin, 2 cases [13Yo] were pyogenic origin. Dyspnea on exertion was evident in all patients and abdominal distention, general weakness, palpitation, peripheral edema were found. Eleven patients showed low voltage of QRS wave, 7 patients showed diffuse ST-T wave change, 2 patients showed atrial fibrillation on EKG. There were 6 patient showed pericardial thickening, 5 patients showed evidence of restriction, 5 patients showed pericardial effusion, 4 patients showed low cardiac output on preoperative echocardiogram. Hemodynamic response to pericardiectomy were observed; preoperative CVP 26.8 cmH2O declined to 15.0 cmH2O. Preoperative NYHA Functional class showed class II - 1, class III - 10, class IV - 4, postoperative NYHA functional class showed class I - 7, class II - 4, class Ill - l.

• Journal of Chest Surgery
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• 제30권8호
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• pp.823-826
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• 1997

심근 농양은 대개 감염성 심내막염이나 패혈증의 합병증으로 생길 수 있다. 심근 농양이 관상 동맥을 압박 하여 심근 허혈을 초래한 경우는 1987년 Cripps 등이 보고한 이래 5-6례 있을뿐이다. 61세 남자 환자가 내원 6주 전부터 시작된 원인을 알 수 없는 발열과 오한을 주소로 내원하였다. 환자는 발열이 시작된지 2주후에 심실 세동 및 이로 인한 심장 마비로 심폐소생술을 시행받은 병력이 있었다. 심에코와 관상동맥 조영 결과 우측 방실구 부위의 심근 농양이 우관상동맥을 외부에서 압박하면서 심근 경색을 초래한 소견을 보였다. 수 술은 농양을 변연 절제하였으며 괴사된 심방벽을 절제한 후 생긴 결손은 자가 심낭을 이용한 patch로 폐쇄하 였고 우측 내유동맥을 우관상동맥의 원위부에 문합하였다. 환자는 합병증없이 퇴원하였으며 수술 중 검체에 서 시행한 농양배양 검사에서는 Salmonella arizona가 동정되었다.

• Journal of Chest Surgery
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• 제26권10호
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• pp.743-748
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• 1993

Alterations in thyroid function test results are frequently seen in patients with nonthyroidal illness & correlate with the severity of the illness & prognosis. We studied thyroid hormone changes in 14 patients received cardiopulmonary bypass[CPB]. All patients were biochemical euthyroidism preoperatively. TSH[Thyroid Stimulating Hormone] level reached its nadir[0.46 $\pm$ 0.11 ulU/ml, P<0.0005] at 12 hours after the start of CPB & showed elevating pattern to the preoperative level thereafter. FT4[Free Thyroxine] reached to its nadir[10.16$\pm$ 1.17 pmol/L, P<0.01] at POD[Post Operative Day] #4 & reached to the preoperative level at POD #7. Mean serum TSH & FT4 concentration were within normal limits[P>0.25] during CPB & thereafter. TT3[Total Triiodothyronine] reached to its nadir[38.6 $\pm$ 8.4 ng/dl, P<0.001] at 30 minutes after the start of CPB & remained low[P<0.05] throughout the study period. The patients whose recovery was uneventful[Group I] had higher serum TSH, TT3 levels[P<0.05] than who had complications or died[Group II]. Group I showed the elevating pattern of TSH, TT3 at POD #4, but Group II failed to show such elevating pattern. In Group I, FT4 was within normal limits[P>0.5] throughout the study period, and also within normal limits[P>0.1] in Group II.

• 대한의용생체공학회:의공학회지
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• 제36권6호
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• pp.264-270
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• 2015

A mock circulatory loop system has been developed to construct a simulator for trainees in cardiopulmonary bypass systems or to simulate a test environment for cardiac-assist devices. This paper proposes a computerized mock circulatory loop system whose node is modularized by using a servo control flow regulator to simulate dynamic change of the hemodynamic status. To observe the effect of time-varying resistance, one with hemodynamic properties, the proposed system replicates the planned cross-sectional areas of the outlet of a ventricular assist device in terms of voltage input of a servo valve. The experiment is performed (1) for steady-input commands of selected area sizes and (2) for dynamic commands such as monotonous increase and decrease, and oscillatory functions of the voltage input, and a computer program based on LabVIEW (National Instruments, Austin, USA) processes every measured data and control command to the servo valve. The results show that the pressure and flow at the target points with respect to time-varying resistance match intuitive estimation: the pressure at the outlet and the pressure drop between both sides of the valve increased and the flow at the outlet decreased for increased resistance.

• The Korean Journal of Physiology and Pharmacology
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• 제13권2호
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• pp.123-129
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• 2009

Aprotinin is used clinically in cardiopulmonary bypass surgery to reduce transfusion requirements and the inflammatory response. The mechanism of action for the anti-inflammatory effects of aprotinin is still unclear. We examined our hypothesis whether inhibitory effects of aprotinin on cytokine-induced inducible nitric oxide synthase (iNOS) expression (IL-$l\beta$ plus TNF-$\alpha$), reactive oxygen species (ROS) generation, and vascular smooth muscle cell (VSMC) proliferation were due to HO-l induction in rat VSMCs. Aprotinin induced HO-l protein expression in a dose-dependent manner, which was potentiated during inflammatory condition. Aprotinin reduced cytokine mixture (CM)-induced iNOS expression in a dose dependent manner. Furthermore, aprotinin reduced CM-induced ROS generation, cell proliferation, and phosphorylation of JNK but not of P38 and ERK1/2 kinases. Aprotinin effects were reversed by pre-treatment with the HO-l inhibitor, tin protoporphyrin IX (SnPPIX). HO-l is therefore closely involved in inflammatory-stimulated VSMC proliferation through the regulation of ROS generation and JNK phosphorylation. Our results suggest a new molecular basis for aprotinin anti-inflammatory properties.

• Journal of Chest Surgery
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• 제16권3호
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• pp.289-294
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• 1983

The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

• Journal of Chest Surgery
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• 제19권1호
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• pp.18-24
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• 1986

The mean perfusion pressure produced by 20 different design and size of disposable aortic perfusion cannulas [size range: 18F to 20F] at flow rates of 1 to 5 L/min was compared. A roller pump with perfusion tubing 10mm in inner diameter was used with a mixture of 0.9% normal saline and 100% glycerin [mixing ratio of 6.72:13.28] to make the viscosity as normal blood in 20oC as the test solution. Line pressure in these cannulas at a flow rate of 3L/min ranged from 13.2$\pm$4.47 to 157$\pm$1 34 mmHg in a case of absence of resistance, and from 11.4$\pm$1.14 to 227.2$\pm$4.47 mmHg in a case of presence of resistances 14 cannulas had gradients of less than 100Hg at a flow rate of 3L/min and 9 cannulas less than 100mmHg at 4L/min. The following results were obtained from this experimental study: .1] A wide range of line pressure was observed in disposable aortic perfusion cannulas currently in clinical use; 2] Some cannulas currently used for cardiopulmonary bypass in adults generated excessive line pressure; 3] Both the material and design affect function, with some designs safer than others. Cardiac surgeons should base the choice of aortic perfusion cannula on the best performance and safest design available to avoid cannula-related problems during operation.

• Journal of Chest Surgery
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• 제18권4호
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• pp.792-799
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• 1985

Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

• Journal of Chest Surgery
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• 제23권3호
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• pp.488-500
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• 1990

Author compared the effect of surgical methods between 40 patients who received mitral valve replacement with complete excision of the mitral valve[resected group] and 41 patients who received mitral valve replacement with preservation of posterior chorda tendineae and posterior mitral leaflet[preserved group] from 1985. 2. to 1989. 4. at cardiothoracic department of Pusan National University Hospital.v 1. There was no significant difference between the preserved group and resected group in cardiopulmonary bypass time and aortic cross clamping time and NYHA classification. 2. In preserved group of Mitral stenosis and Mitral regurgitation, the left ventricular functions were much improved after mitral valve replacement than resected group, but there was not so difference between the preserved group and reserved group in Mitral steno-regurgitation. 3. There were remarkable decrease in complication rate in preserved group compared to resected group. And also the death rates were remarkably decreased in preserved group which was 4.9% compared to resected group which was 17.5%. As the preservation of the posterior mitral leaflet and chorda tendineae during mitral valve replacement in mitral valve disease showed significantly improved effects in the maintaining of left ventricular function and reducing the postoperative complication, I assume the preservation of posterior mitral leaflet and chordae during mitral valve replacement will bring better result.

• Journal of Chest Surgery
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• 제23권3호
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• pp.430-437
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• 1990

We clinically evaluated 121 cases of ventricular septal defect which we operated from April, 1986 to December, 1989 at Inha General Hospital, Seong-Nam, Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University. These patients were occupied 54.8% of all congenital heart diseases operated on its same period. Of the 121 patients, 63 patients were male[52.1%] and 58 patients were female[47.9i]. The two most common symptoms were frequent upper respiratory infection and dyspnea on exertion. By Kirklin s anatomical classification, type I constituted 34.7%, type II 61.98%, type III 0.03% and type IV not occupied. Associated cardiac anomalies were found in 34 cases, and PDA was most common associated anomaly, occupied in 22 cases. On the cardiac catheterization data, there were statistically significant correlation between VSD size[cm2 /BSAm2] and systolic pulmonary arterial pressure[sPAP], pulmonary to systemic flow ratio[Qp/Qs] & pulmonary to systemic pressure ratio[Pp/Ps] respectively, Type II [r=0.53, p<0.01] was more correlated than type I [r=0.49, p<0.05] between VSD size and Qp /Qs. We could not found the correlationship between age and Qp/Qs [Type I; r=0.16, Type II; r=-0.15] All cases were operated under cardiopulmonary bypass and 58 cases[46.3%] were operated through the right atrial approach, and 34 cases[28.1%] through the pulmonary arterial approach. Operative mortality rate was 4.13%[5 cases].