• 대한수의학회지
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• 제41권2호
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• pp.233-241
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• 2001

Dirofilaria immitis, the causative agent of canine heartworm disease, inhabits mainly in the pulmonary arteries and the heart of dogs and cats, causing circulatory and respiratory disorders. Although diagnosis of the disease is based on the presence of microfilaria in the peripheral blood or of specific antigens released from the adult worms into the peripheral blood, the severity of the infection and the assessment of disease progression are based on the clinical signs and radiographic image analysis. We analysed 12 mixed-bred Jindo dogs naturally infected with Dirofilaria immitis without any clinical signs and compared the radiographic images of the heart and the lung with the number of adult worms at necropsy. The dorsoventral radiographs of 12 infected dogs revealed that the right caudal lobar pulmonary arteries (RCaLPA) were dialated in 66.7% of dogs, whereas the main pulmonary artery segment was enlarged in 50.3% of dogs. The cranial lobar pulmonary arteries (RCrLPA) were dilated or pruned in 33.3% of dogs. All dogs displayed the interstitial lung pattern, while the vertebral heart size (VHS) was of normal range. Although a range of 9 to 166 adult worms (av. 45.6) was found in the pulmonary arteries, in the heart or in the vena cava, no correlation with the radiographic findings and/or with the clinical signs was observed.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1191-1203
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• 1990

Pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries [abbreviated as PA+VSD+MAPCA in the following] has limited the success of attempts at accurate diagnosis and complete surgical repair. From April 1986 to September 1990, 23 patients with PA+VSD+MAPCA among 96 patients of PA+VSD in Seoul National University Children’s Hospital were encountered. The group comprised 14 male and 9 female patients with ages ranging from 17 days to 177 months [mean 49.6 months]. We operated one stage total repair on good pulmonary artery sized two patients by R.E.V. [Reparation a l’etage ventriculaire] and Rastelli operation respectively. And the 11 patients who had independent MAPCAs and hypoplastic central pulmonary artery were dealt with unifocalization and modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients later. We successfully had managed 7 patients whose MAPCAs could be ligated with modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients with R.E.V or Rastelli operation. Recently, three obstruction after 11 unifocalization procedures made us to try palliative right ventricle-pulmonary artery conduit operation by Gore-Tex vascular graft interposition under cardiopulmonary bypass. And so we managed another 3 patients with these procedures for the purpose of pulmonary artery growth whose central pulmonary artery were severely hypoplastic. We experienced one death after second stage repair whose central pulmonary artery was created by 12mm Gore-Tex vascular graft and was unifocalized.

• The Korean Journal of Physiology and Pharmacology
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• 제21권6호
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• pp.591-598
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• 2017

Propofol is known to cause vasorelaxation of several systemic vascular beds. However, its effect on the pulmonary vasculature remains controversial. In the present study, we investigated the effects of propofol on human pulmonary arteries obtained from patients who had undergone surgery. Arterial rings were mounted in a Multi-Myograph system for measurement of isometric forces. U46619 was used to induce sustained contraction of the intrapulmonary arteries, and propofol was then applied (in increments from $10-300{\mu}m$). Arteries denuded of endothelium, preincubated or not with indomethacin, were used to investigate the effects of propofol on isolated arteries. Propofol exhibited a bifunctional effect on isolated human pulmonary arteries contracted by U46619, evoking constriction at low concentrations ($10-100{\mu}m$) followed by secondary relaxation (at $100-300{\mu}m$). The extent of constriction induced by propofol was higher in an endothelium-denuded group than in an endothelium-intact group. Preincubation with indomethacin abolished constriction and potentiated relaxation. The maximal relaxation was greater in the endothelium-intact than the endothelium-denuded group. Propofol also suppressed $CaCl_2$-induced constriction in the 60 mM $K^+$-containing $Ca^{2+}$-free solution in a dose-dependent manner. Fluorescent imaging of $Ca^{2+}$ using fluo-4 showed that a 10 min incubation with propofol ($10-300{\mu}m$) inhibited the $Ca^{2+}$ influx into human pulmonary arterial smooth muscle cells induced by a 60 mM $K^+$-containing $Ca^{2+}$-free solution. In conclusion, propofol-induced arterial constriction appears to involve prostaglandin production by cyclooxygenase in pulmonary artery smooth muscle cells and the relaxation depends in part on endothelial function, principally on the inhibition of calcium influx through L-type voltage-operated calcium channels.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.279-284
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• 2017

Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

• 대한수의학회지
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• 제40권4호
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• pp.729-739
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• 2000

Echocardiography, vital signs, microfilaremia, and blood chemistry of 12 Jindo dogs naturally infected with canine heartworms (Dirofilaria immitis) were analysed and compared with those of 5 uninfected control Jindo dogs. Nine of the twelve infected dogs contained microfiaria in the peripheral blood, whereas the presence of adult heartworms in the pulmonary arteries and/or in the heart was detected from four dogs by echocardiography. Among the four echocardiography-positive dogs, two dogs also displayed evidence of heartworms in the right ventricle by echocardiography. Upon necropsy, a total of 547 adult worms was collected from the 12 infected dogs (av = 45.6, range = 9-166). Dogs with positive echocardiograpic images of heartworms contained 48, 74, 104 and 166 adult worms in the heart, pulmonary arteries and/or in the caudal vena cava (av. 98.0), whereas 9 to 39 worms (av. 19.4) were collected from those organs of dogs with negative echocardiography. Most heartworms were found in the right ventricle (438, 80%) at necropsy, whereas relatively fewer worms were found in the pulmonary arteries (96, 17.6%), and in the caudal vena cava (13, 2.4%). The necropsy findings on the location of adult worms significantly differed from the results of echocardiographic analysis in which the right ventricle of most dogs did not show the presence of heartworms. These results indicated that the adult heartworms had been located in the terminal branches of the pulmonary arteries when the host was alive, but the worms moved toward the right ventricle shortly after the heart of the infected dogs stopped beating. Microfilaremia in the peripheral blood was the highest in the blood samples collected at 10 pm. However, the correlation between the number of microfilaria and of adult worms was not observed. Clinical and vital signs of infected dogs did not show any significant difference before and after a 30 minute-exercise at 5 km/hr compared to those of uninfected control dogs.

• Journal of Chest Surgery
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• 제33권2호
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• pp.195-198
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• 2000

Primary sarcomas of the pulmonary arteries are and the clinical presentation closely resembles several more common conditions, Therefore they are seldomly diagnosed preoperatively without a pathologic esxamination of sufficient surgical specimen. Treatment of these tumors remains primarily surgical as possible and the role of the adjuvant chemotherapy and radiotherapy is not yet evident We report a case of primary sarcoma of pulmonary artery clinically suspected of carcinoid partially involving the pulmonary parechyme and the bronchus mainly in the left main pulmonary artery and the vein with left intrapericardial pneumonectomy.

• Journal of Chest Surgery
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• 제10권1호
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• pp.106-112
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• 1977

Transposition of the great arteries is one of the commonest forms of severe congenital heart disease and produces severe cyanosis threatening survival from the day of birth. Anatomical anomalies which the aorta arises from the infundibulum of the right ventricle and the pulmonary artery arises from the outflow tract of the left ventricle make the deranged circulation. Survival is possible only if additional anomalies are present which allow mixing of the pulmonary and systemic circulations. Preoperative diagnosis as TGA was taken on the 15 day old female via the preoperative examination and the right cordioangiography. As palliative treatment for cyanosis, Blalock-Hanlon operation was performed in this patient. The results were good as 54 mmHg changed from 27 mmHg of $PO_2$ in aorta, but sudden cardiac arrest was developed in postoperative 12 hours. In order to confirm the cause of death and the cardiac anomalies, autopsy was performed on the date of death. The diagnosis of the autopsy showed; [1] Transposition of the Great Arteries. [2] Patent Ductus Arteriosus. [3] Patent Foramen Ovale. [4] Ventricular Septal Defect, 2 Muscular Type. [5] Double Ureter, Right. [6] Artificial Atrial Septal Defect. [7] Total Collapse of the left lung and Intraparenchymal hemorrhage of right lung.

• Journal of Chest Surgery
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• 제21권4호
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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.

• Journal of Chest Surgery
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• 제44권6호
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• pp.432-436
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• 2011

We herein present a case of a successful correction of cor triatriatum associated with thrombotic pulmonary hypertension diagnosed in an adult female patient. We confirmed diagnosis using transthoracic and transesophageal echocardiography in addition to cardiac computed tomography and magnetic resonance imaging. Surgical repair comprised excision of the fibromuscular membranous septum in the left atrium, patch closure of an atrial septal defect, and reconstruction of the pulmonary arteries with a vascular graft. Cor triatriatum complicated pulmonary thrombotic hypertension with atrial septal defect is amenable to surgical correction with satisfactory results.

• Applied Microscopy
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• 제21권1호
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• pp.86-107
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• 1991

An experimental study was performed to observe the early effects of monocrotaline on pulmonary vascular system by means of light microscopy and scanning electron microscopy, attempting to expore the mechanism behind the process of pulmonary hypertension. Experimental animal(Sprague-Dawley male rats ; 150-200g B. W.) were intra-peritoneal administered with 100mg/kg B. W. monocrotaline. Authors observed light microscopically various gradational increase of wall thickness in pulmonary muscular and non-muscular arteries in duration from 2 weeks to 5 weeks after monocrotaline administration and the changes were more sever in the latter than the former. The scanning electron microscopy shows severe and diffuse endothelical cell swelling, microvilli and microbleb formation since 1 hour after monocrotaline administration and during the course, after 5 hours the severity of endothelial cell damage was prominent with presence of fibrin, webs, platelet thrombi and white cell adherence. It was concluded that the monocrotaline primarily induced severe and diffuse endothelial cell damage of pulmonary arteries and laterly added the participation of platelets, which attributed to the pathogenesis of monocrotaline induced pulmonary vascular lesions in relation to pulmonary hypertension.