• Journal of Chest Surgery
• /
• 제16권2호
• /
• pp.175-183
• /
• 1983

Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

• Journal of Chest Surgery
• /
• 제30권7호
• /
• pp.724-728
• /
• 1997

68세된 남자로 좌측과 후측 흉부에 통증을 주소로 내원하였다. 술전 시행한 흉복부 W scan에서 대동맥류는 좌측 쇄골하동맥에서 횡격막까지 연결되었고 긴박성 파열의 소견도 보였다. 또한 술전 관동맥조영술에서는 좌회선동맥에 95%, 좌전하행지에 50%의 협착소견을 보였다. 수술은 고동맥-고정맥 우회술을 하면서 좌측 제 4늑간을 통하여 측후방 개흉절개를 하여 수술시야를 확보하였고 대동맥을 차단한뒤 대동맥류를 절개하고 인조혈관으로 대치하였다. 그리고 심박동하에서 대복제정 맥을 이용하여 좌회선동맥의 두번째 둔각변연동맥과 좌측 쇄골하동맥 기시부에 관상동맥 우회술을 하였다. 술후 환자는 술중 저혈압성 쇼크와 저산소증으로 다발성 뇌경색의 합병증을 보였다.

• The Journal of Korean Physical Therapy
• /
• 제33권4호
• /
• pp.179-186
• /
• 2021

Background: Patients with advanced asthma and chronic obstructive pulmonary disease (COPD) have postural deviations such as thoracic hyperkyphosis, forward shoulder posture (FSP) due to an increase in head and cervical protraction, reduced shoulder range of motion and a corresponding increase in scapula elevation and upward rotation. Unlike congenital vertebral kyphosis that are permanent and rigid deformities with bony and other structural deformations which cause respiratory impairment, these deformities in these patients may be more flexible. Since the thoracic hyperkyphosis has been implicated as having adverse health consequences it is necessary to evaluated the relationship between thoracic kyphosis and cardiopulmonary functions of patients with COPD and asthma. Methods: It was a cross-sectional analytical study. Eighty-four eligible patients with COPD and asthma were recruited from the Respiratory Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), and basic anthropometric parameters, pulmonary parameters, cardiovascular parameters, thoracic kyphosis (Cobb) angle and presence of respiratory symptoms of participants were assessed. Data was analyzed using SPSS version 20. Results: There was no significant correlation between the thoracic kyphosis and selected pulmonary parameters (Forced Expiratory Volume in one second (FEV1, p=0.36), Forced Vital Capacity (FVC, p=0.95), Peak Expiratory Flow Rate (PEFR, p=0.16), Thoracic expansion (TE, p=0.27)/cardiovascular parameters (Systolic Blood Pressure (SBP, p=0.108), Diastolic Blood Pressure (DBP, p=0.17) and Pulse Rate (PR, p=0.93) as well as the respiratory symptoms (SGRQ scores, p=0.11) in all subjects. Conclusion: There was no relationship between thoracic kyphosis and selected pulmonary/cardiovascular parameters as well as respiratory symptoms in patients with COPD and asthma.

• Journal of Chest Surgery
• /
• 제24권11호
• /
• pp.1068-1073
• /
• 1991

Bleeding after open heart surgery with cardiopulmonary bypass was a cause of concern. requiring reexploration of the chest in approximately 8 percent of patients who have had operations on the heart. From April., 1983 to October, 1991, 16 patients[2%] out of 777 patients who underwent open cardiac surgery had emergency reexploration with bleeding at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. In 12 cases[75%], reexploration was performed for continuous bleeding and the reminder[4 cases] were performed for suspected tamponade & hypotension. There were 9 cases[56%] of congenital heart disease and 7 cases of acquired heart disease. The mean blood loss were 997$\pm$472ml /sq. M in total cases and 1442$\pm$ 647ml /sq. M in cases repair of cyanotic heart disease. The mean interval till reoperation was 16.6hr [1hr~72hr] and 41 hr[12~72hr] in tamponade cases and 8.4hr[1hr~24hr] in continuous bleeding cases. The bleeding sites were identified in 7 cases: aortotomy site in 2 cases, ventriculotomy site, SVC, thymus, pleura and sternum wiring site in each other case. But no specific sites was found in the remaining 9 cases. The 8 cases had complications but all except 1 cases with hypoxic brain damage were recovered without sequale. We conclude that emergency thoractomy after open heart surgery may be lifesaving and-/or diminishing complications with bleeding if performed promptly with excessive bleeding, tamponade and unexpected hypotension.

• 대한물리치료과학회지
• /
• 제18권2호
• /
• pp.9-15
• /
• 2011

Purpose: The purpose of this study was to provide the information of renal disease patients and to provide evidence the physical therapy recipient of renal disease patients. The reviews suggest that renal disease patients are physical inactivity situation, increase on cardiopulmonary risk factor, developed complication disease, increased psychosocial factor like depress and anxiety, decreased Quality of life because their disease effects. Thus. exercise program seems to have beneficial effect on physiologic and psychosocial functioning, Quality of life. It is expected that this study will consider rehabilitation program for internal medicine patients and should be consider as availability of therapeutic exercise program on understanding renal disease in physical therapy.

• Journal of Chest Surgery
• /
• 제27권7호
• /
• pp.624-627
• /
• 1994

Congenital coronary arteriovenous fistula is a rare cardiac defect that causes coronary arterial flow to drain into the right cardiac chambers, the pulmonary artery, the coronary sinus, or the left cardiac chambers. The most frequently involved vessel is the right coronary artery. We experienced a case that had a coronary arteriovenous fistula associated with valvular heart disease. With the cardiopulmonary bypass done under hypothermia, mitral valve replacement was accomplished and the fistulas of both proximal and distal portions of the right coronary artery were closed with 3-0 prolene. Postoperative course was uneventful.

• Journal of Chest Surgery
• /
• 제32권6호
• /
• pp.518-524
• /
• 1999

배경: 본 연구에서는 개심술을 시행받은 소아 환아에 대하여 심폐기 이탈 직후 실시한 변형 초여과법의 효과를 임상례의 분석을 통하여 입증하였다. 대상 및 방법: 1997년 1월부터 12월까지 변형 초여과법을 실시한 체중 7 kg 이하의 청색성 심질환을 보이는 50명의 환아들과 변형 초여과법을 실시하지 않은 체중 7 kg 이하의 청색성 심질환을 갖은 50명의 환아들을 대상으로 하여 초여과 전후의 적혈구용적률, 혈역학적 수치와 체중의 변화를 비교하였다. 결과: 평균나이는 변형 초여과군이 4.1개월, 대조군이 3.1개월이었으며, 체중은 변형 초여과군이 4.8 kg, 대조군이 4.6 kg으로 두 군 간에 통계적인 차이가 없었다. 변형 초여과군에서는 평균 7분 동안 매 환아당 60.0$\pm$29.2 cc/kg의 수액을 여과시켰다. 변형 초여과 직후에는 적혈구용적률이 36.1%로 대조군의 26.4%에 비해 유의하게 높았다(p=0.001). 심폐우회술후 흉관을 통한 배액량은 두 군간에 차이가 없었으나(p=0.28), 수혈량은 변형 초여과군이 대조군에 비해 유의하게 적었다(p=0.04). 변형 초여과후 중심정맥압이 감소하였고(p=0.02) 수축기(p=0.0001)와 이완기혈압(p=0.0001)은 증가하였고 맥박수는 감소하였으나(p=0.02), 대조군에서는 유의한 차이가 없었다. 변형 초여과후 체중의 증가는 대조군에 비해 유의하게 감소하였다(p=0.04). 결론: 연구자들은 본 연구를 통하여 소아환아의 개심술에 적용된 변형 초여과법이 조작이 간편하고 효과적으로 혈액을 농축시키고, 단시간내에 정상 혈역학으로의 환원을 가능케 하였으며, 술후 체수분 조절에도 탁월하여 수술결과를 보다 양호하게 만들 수 있다는 사실을 입증하였다.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2009년도 추계학술대회 논문집
• /
• pp.43-44
• /
• 2009

• Journal of Chest Surgery
• /
• 제27권11호
• /
• pp.914-921
• /
• 1994

From May 1977 to November 1993, 1, 500 cases of open heart surgery were performed under the cardiopulmonary bypass. In 1500 cases of open heart surgery 975 cases[65%] were congenital heart disease and 525 cases[35%] were acquired heart disease. In 975 cases of congenital heart disease, there were 812 cases[83%] of acyanotic congenital heart anomaly and 163 cases of cyanotic congenital anomaly. In 525 cases of acquired heart disease, most cases were valvular heart disease in which 557 valves were implanted. The each operative mortality of congenital and acquired disease was 7.7% and 7.4% respectively and then overall mortality rate was 7.6%. There has been increasing incidence of open heart surgery in infants in recent years. After 1990, 28 cases of infant open heart surgery below the 12month were performed. Most lowest weight was 2, 200g[15 days]. Operative mortality of open heart surgery in infant with weight below the 10kg was very high as a 25.7%.

• Journal of Chest Surgery
• /
• 제16권2호
• /
• pp.147-156
• /
• 1983

Over a period from May, 1977 to SEptember, 1982, 101 cases ofopen heart surgerywere done under cardiopulmonary bypass. There were 50 male and 51 female patients, and the ages of the patients ranged from 19 months to 48 years. Sixty-nine cases were congenital heart disease and 32 cases were acquired heart disease, which consisted of 30 valvular disease, 1 IVC obstruction, and 1 myxoma. Among the 30 cases of valvular disease, 12 MVR, 4 MVR+TAP, 2 MVT+AVR, 1 MAP, and 11 OMC were done. There were 3 operative deaths (17.5%) in 16 MVR, 1 in 2 MVR+AVR, and 1 in 11 OMC. Operative mortality in 69 congenital heart disease was 13.0% ; 3 deaths (6.7%) in 45 acyanotic and 6(25.0%) in 24 cyanotic cases. The overall mortality for 101 cases was 14.8%; 13.0% for congenital and 18.8% for acquired heart disease.