• Journal of Chest Surgery
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• 제49권1호
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• pp.42-45
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• 2016

Thrombosis at the left ventricular outflow tract occurs without any detectable heart disease or predisposing factors only extremely rarely. A 48-year-old male visited Konkuk University Medical Center with loss of consciousness one month prior to presentation. Before he visited our hospital, he had been diagnosed with a cardiac tumor, which was located between the left atrium and posterior aortic root, and which was adjacent to both the aortic and mitral valves. Cardiac transplantation was recommended at the other hospital because of the high risk of cardiac dysfunction induced by both aortic and mitral valvular dysfunction after surgical resection. Based on preoperative transthoracic echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and intraoperative transesophageal echocardiography, we considered it to be a benign tumor. Complete resection was achieved and the pathology confirmed organizing thrombus. We report a case of organizing thrombus mimicking a cardiac tumor, which was located at the mitral-aortic intervalvular fibrosa of the left ventricular outflow tract without any heart disease.

• Korean Journal of Radiology
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• 제21권6호
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• pp.647-659
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• 2020

Objective: The occurrence of intramyocardial hemorrhage (IMH) and microvascular obstruction (MVO) in myocardial infarction (MI), known as severe ischemia/reperfusion injury (IRI), has been associated with adverse remodeling. APT102, a soluble human recombinant ecto-nucleoside triphosphate diphosphohydrolase-1, can hydrolyze extracellular nucleotides to attenuate their prothrombotic and proinflammatory effects. The purpose of this study was to temporally evaluate the therapeutic effect of APT102 on IRI in rats and to elucidate the evolution of IRI in the acute stage using cardiovascular magnetic resonance imaging (CMRI). Materials and Methods: Fifty-four rats with MI, induced by ligation of the origin of the left anterior descending coronary artery for 60 minutes, were randomly divided into the APT102 (n = 27) or control (n = 27) group. Intravenous infusion of APT102 (0.3 mg/kg) or placebo was administered 15 minutes before reperfusion, and then 24 hours, 48 hours, 72 hours, and on day 4 after reperfusion. CMRI was performed at 24 hours, 48 hours, 72 hours, and on day 5 post-reperfusion using a 7T system and the hearts were collected for histopathological examination. Cardiac function was quantified using cine imaging and IMH/edema using T2 mapping, and infarct/MVO using late gadolinium enhancement. Results: The extent of infarction (p < 0.001), edema (p < 0.001), IMH (p = 0.013), and MVO (p = 0.049) was less severe in the APT102 group than in the control group. IMH size at 48 hours was significantly greater than that at 24 hours, 72 hours, and 5 days after reperfusion (all p < 0.001). The left ventricular ejection fraction (LVEF) was significantly greater in the APT102 group than in the control group (p = 0.006). There was a negative correlation between LVEF and IMH (r = -0.294, p = 0.010) and a positive correlation between IMH and MVO (r = 0.392, p < 0.001). Conclusion: APT102 can significantly alleviate damage to the ischemic myocardium and microvasculature. IMH size peaked at 48 hours post reperfusion and IMH is a downstream consequence of MVO. IMH may be a potential therapeutic target to prevent adverse remodeling in MI.

• Korean Journal of Radiology
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• 제22권5호
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• pp.697-705
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• 2021

Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

• Journal of Chest Surgery
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• 제38권3호
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• pp.249-252
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• 2005

상완 신경총에 발생하는 종양은 비교적 드물다 저자들은 상완 신경총의 하부 신경간에 발생한 신경초종을 미세현미경 수술로 치료하였기에 보고한다. 38세 남자 환자가 우측 쇄골상부 및 전완부의 6, 7번 경부신경 지배영역에 통증을 호소하였다. 고무탄력의 딱딱한 종괴가 우측 쇄골 상부에서 촉지되었고 자기공명영상소견 상 우측 상완 신경총 부위에 주위와 경계가 뚜렷하고 낭성 부위를 포함하며 조영제에 잘 조영되는 타원형의 종괴였다. 상완 신경총 종양은 전방 경흉부 접근법(Dartevelle 변형술식)을 통해 완전히 제거되었다. 수술 후 3개월째 아무런 신경 증상이 없이 외래 추적관찰 중이다.

• Journal of Chest Surgery
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• 제48권5호
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• pp.335-344
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• 2015

Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

• Journal of Chest Surgery
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• 제40권11호
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• pp.793-797
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• 2007

Communicating bronchopulmonary foregut malformation (CBPFM)은 매우 드문 선천성 기형으로 격리된 호흡계 조직과 식도 또는 위장 사이의 누관이 특징적이다. 원시위장관에서 기원한 부속의 폐조직이 모든 종류의 bronchopulmonary furegut malformation 발생의 중요한 요인이 된다. 반복되는 폐렴이 있는 환자의 chest X-ray에서 낭성 병변이 보인다면 CBPFM을 생각해봐야 하며, 진단적 방법으로 식도조영술, 기관조영술, 컴퓨터 단층촬영, 자기공명영상 그리고 혈관조영술 등이 도움이 된다. 치료는 수술적 제거가 권장되며 예후도 좋다. 좌측 완전 심낭결손증과 동반되었으며, 이중식도에 연결된 외엽성 폐격리증과 기관지성 낭종을 보인 CBPFM 1예를 보고한다.

• Journal of Chest Surgery
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• 제50권4호
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• pp.270-274
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• 2017

Background: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. Methods: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was $43.5{\pm}12.2years$ and the mean peak pressure gradient between the upper and lower extremities was $54.8{\pm}39.0mm\;Hg$. The median follow-up duration was 54.4 months (range, 17.8 to 177.4 months). Results: There were no cases of operative mortality. The mean peak pressure gradient significantly decreased to $-2.4{\pm}32.3mm\;Hg$ (p=0.017 compared to the preoperative value). Late death occurred in 2 patients. The symptoms of upper extremity hypertension and claudication improved in all patients. The bypass grafts were patent at $47.1{\pm}58.9months$ in 7 patients who underwent follow-up imaging studies. Conclusion: An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.

• 대한핵의학회지
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• 제39권6호
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• pp.407-412
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• 2005

Echocardiography is one of the most frequently used techniques for diagnosing cardiovascular diseases. Over the last twenty years, technological advances have enabled the application of high-quality imaging. Important recent developments have occurred in echocardiography that are already being used clinically. Equipment and hardware is now available to produce reai time three-dimensional and contrast enhanced imaging.. Tissue Doppler and stress echocardiography have provided potential benefit to analyze hemodynamic information of heart. This review discusses each of these new developments and their potential impact on the practice of echocardioaraphy and cardiology in general.

• International Journal of Vascular Biomedical Engineering
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• 제2권1호
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• pp.1-10
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• 2004

Circulatory disease is the number two cause of death next to cancer in Korea, while the cardiovascular disease alone is the number one cause of death in the US. In the present article, some background, current status and future prospects of biomedical engineering esearch on circulatory disorders are discussed in terms of the origin of atherosclerosis, computational fluid dynamics and medical imaging techniques, clinical treatments and fluid dynamics, advances in stents, hemodynamic analysis of artificial heart, and artificial blood. In particular, the importance of close collaboration of medicine and fluids engineering is emphasized.

• Journal of Chest Surgery
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• 제35권9호
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• pp.701-703
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• 2002

지금까지는 다한증에 대한 흉부교감신경 수술 후 보상성 발한에 대한 평가를 주로 환자들의 주관적인 증상에 의존함으로써 그 결과의 객관성과 타당성이 문제가 되었다. 이에 본 교실에서는 이러한 문제점들을 해결하고자 환자의 주관적인 증상과 더불어 객관적인 검사방법으로 컴퓨터 적외선 체열촬영(D.I.T.I : Digital Infrared Thermographic Imaging)을 활용하여 다한증 수술 후 보상성 발한의 부위 및 정도를 정확하고 객관적으로 확인하고자 하였다.