• Journal of Chest Surgery
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• v.49 no.4
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• pp.292-294
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• 2016

Cardiac resynchronization therapy (CRT) is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D). After CRT-D, left ventricular ejection fraction improved from 22% to 4 4% assessed by echocardiogram 1 year postoperatively. On electrocardiogram, QRS duration was shortened from 206 to 144 ms. The patient's clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option.

• The Korean Journal of Pain
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• v.23 no.4
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• pp.262-265
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• 2010

Histologically, Schmorl's nodes are defined as the loss of nuclear material through the cartilage plate, growth plate, and end plate into the vertebral body. Most Schmorl's nodes are asymptomatic, although there are some reports of symptomatic Schmorl's nodes, which should be treated similarly to vertebral compression fractures, with conservative treatment as the first choice. We report the case that we reduced the pain by blocking the ramus communicans nerve in a patient with Schmorl's node.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.132-135
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• 1999

Although the vast majority (about 70%) of patients with cancer will have pain directly related to neoplastic invasion into pain-sensitive bone and soft tissue structures,as many as 20% of the adults will have pain caused directly by cancer therapy. Treatment related pain problems are important for several reasons; their appearance may be confused with more omnious pain syndromes associated with tumor recurrence or progression that may be directly lead to death of the patient; when severe, compliance with recommandations for further therapy may be adversely affected. Now, we report a case of postsurgical pain syndrome after radical neck dissection in a patient with tonsilar cancer. The pain after radical neck dissection result from injury to the cervical plexus,cranial nerve,and cervical sympathetics. In our case, we ruled out soft tissue infection and tumor recurrence,and successfully treated with gasserian ganglion block with pure alcohol in the patient having neuropathic pain in the mandible and preauricular region after radical neck dissection.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.11-17
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• 1995

Fourty-three infants underwent intracardiac repairs within the first 12 months of life. Mean age was 7 months and mean weight was 6.7 kg. A quarter of them were below 5 kg. Overall mortality including complex anomalies was 17.9%. Thirty-four infants with a ventricular septal defect[VSD were treated. Three infants[8.8% died in the early postoperative period, but only one[3.7% of the infants without having associated lesions was dead. VSD was repaired either by the incision on the right atrium, pulmonary artery, or right ventricle. Postoperative right bundle branch block[RBBB occurrence were different according to the approach: 30.8 % in pulmonary arteriotomy, 37.5 % in atriotomy, and 42.8 % in ventriculotomy. Surgically induced heart block did not occur in any patient, but 10 had temporary arrhythmia, and 11 patients were under temporary pacing from one day to 4 days without any persisting rhythm disturbances. Pulmonary hypertension was present in 29 infants preoperatively, and seven of them developed postoperative elevation of the pressure. Infants complicated with pulmonary hypertensive crisis were managed successfully. Inotropics were necessary in 55.8 % of the infants and vasodilators in 37.2 %. Platelet transfusion were needed in 10 cases who required 272 ml in average, but one who died from sepsis consumed 5,370cc of platelets. And we discuss complications and causes of deaths.

• Journal of Chest Surgery
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• v.16 no.4
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• pp.547-554
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• 1983

Implantation of Dual Chamber Pacemakers Which sense in the Atrium and the Ventricle, and sequentially or synchronously trigger impulses in the both chambers, has led us to the near realization of the ideal "Physiologic Pacing". We have experienced two cases of implantation of Dual chamber pacemaker in September and October, 1983. One patient was a 21-year-old male who had postoperative complete heart block since he was taken Total correction of TOF in May, 1983 . We implanted transvenously a dual chamber pacemaker, VDD type, through the left subclavian vein. In the other patient who came to the emergency room for partial obstruction of small bowels with severe abdominal pain, nausea and vomiting, in whom heart block was found, we implanted a DDD type pacemaker through the left subclavian puncture. The pacemakers have been functioning well postoperatively for more than two months, and the conditions of patient were uneventful.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.748-756
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• 1988

Transaortic closure of ventricular septal defect, suturing a patch on the morphological right ventricular side in patients with congenitally corrected transposition of great arteries might help to avoid postoperative complete heart block if the aorta is large and the subaortic conus is not well developed. In two patients[aged 6 and 16 years] with congenitally corrected transposition of great arteries, ventricular septal defect, and pulmonary stenosis, transaortic closure of ventricular septal defect was performed. No postoperative complete heart block resulted. One hospital death occurred because of sepsis who had underwent reoperation due to bleeding from the aortotomy site. Minimal aortic regurgitation developed in another patient.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.255-257
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• 1993

Shoulder Hand Syndrome is used to describe painful disabilities of the upper extremity due to disturbances of sympathetic nerve supply. A 72 year old male developed hemiplegia on left side on the 5 days after open heart surgery of aortic valve replacement. Three months later, the patient complained of severe pain in the left upper extremity involving shoulder. The left hand showed swelling and flaccid paralysis. Thereafter the left stellate garglion block with 10 ml of l% lidocaine produced prompt pain relief. Thereafter the patient received 94 stellate ganglion block during 7 months which produced permanent remission of pain throughout a 1 year follow period. We recommand sympathetic block for of Shoulder Hand Syndrome following hemiplegia.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.76-79
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• 2013

During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.

• Journal of Veterinary Clinics
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• v.40 no.1
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• pp.50-55
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• 2023

A 10-year-old spayed female Cocker spaniel weighing 6.64 kg was presented with a sign of syncope. Electrocardiographic findings revealed pathologic atrioventricular (AV) block alternating 3rd degree AV block, non-responsive to atropine. Before pacemaker implantation, several anti-hypertensive medications were administered, but there was no improvement. After pacemaker implantation, the heart rate and systemic arterial systolic blood pressure were immediately improved. This is the first report on the resolution of an AV block and malignant systemic hypertension after a pacemaker implant in veterinary medicine.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.115-120
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• 1983

We implanted pacemakers using screw-in sutureless myocardial electrode in 40 patients between February, 1980 and November, 1982 at Seoul Nation University Hospital. Mean age of total patient who received the pacemaker implantation was 39.9 years, but excluding the patient who received the open heart surgery, mean age was 49.3 years. Cause of pacemaker implantation was complete A-V block in 13 patients, symptomatic sick sinus syndrome in 12 patients, complete A-V block after open heart surgery in 12 patients, second degree A-V block with dizziness in one patient, and atrial fibrillation with slow ventricular response in two patients. In thirty nine cases, electrodes were implanted by subxiphoid approach, on the diaphragmatic surface of right ventricle. I n one case, electrode was implanted through the left anterior thoracotomy. Acute stimulation threshold, measured in 35 patients, varied from 0.1 to 2.5 mA [mean 0.85 mA.], and R-wave amplitude [sensitivity], measured in 19 patients, varied from 2.9 mV to 11.5 mV [mean 7.6 mV]. There was no hospital death. The postoperative complications included wound seroma in two patients [5%], wound hematoma in three patients [7.5%], and pacing failure in one patient [2.5%]. The subxiphoid implantation of the pacemaker using sutureless myocardial lead was valuable in obtaining safe, reliable and long-term impulse generation.