• Journal of Chest Surgery
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• v.35 no.9
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• pp.668-671
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• 2002

Anomalous origin of the coronary artery in children is a rare disease. Especially anomalous origin of the left coronary artery from pulmonary artery(ALCAPA) is a fatal condition in neonates with myocardial failure. Among the ALCAPA, origin of the circumflex coronary artery from the pulmonary artery is an extremely rare congenital coronary anomaly. We report a case of reimplantation of the left circumflex coronary artery from the left pulmonary artery to the ascending aorta in a 4-year-old girl.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.277-283
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• 2017

Background: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. Methods: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. Results: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036-1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376-29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388-34.998; p=0.018) were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.265-270
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• 2000

Occasionally, apoplexy is caused by functional or physiologic cardiopulmonary abnormality. In addition, theses may become the factor of aggravating apoplexy and involve complication. If patient has cardiopulmonary disease, progressing of apoplexy is commonly used to be accelerate and prognosis is deteriorative. There by the patient who has cardiopulmonary disease, should be particularly treated for cardiopulmonary disease. We got good result, during treat Soeumin cerebral vascular infarction patient who has pulmonary edema leaded from congestive heart failure, with Sasang Constitutional treatment. Therefore I reported them here. She was 68 years old, female patient. She visited our hospital for apoplexy with right side hemiparesis, dysphagia, dysphasia. After her admission into our hospital, we knew that she has congestive heart failure. The diagnosis is established. She presented with severe general edema and pulmonary edema. Although Soeumin edema usually classified as Taiyin Disease, we classified this as Shaoyin Disease, through diet, discharge, sleep, tongue and symptoms. We has prescribed Gungguichongsoyijung-tang(芎歸蔥蘇理中湯) in accordance with the principle of invigorating the Spleen and lower Yin(建碑而降陰). And her symptoms has improved.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.212-219
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• 1989

We utilized pulmonary artery pressure monitoring system in risky patients for preventing the postoperative pulmonary hypertensive crisis and for sampling the mixed venous blood. And this mixed venous blood oxygen saturation [MVSO2] or partial pressure [MVPO2]tells us many meaningful patients state. We selected 59 cyanotic congenital heart diseased patients, who were operated in our hospital from Nov. 1987 to Oct. 1988, in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital, who had pulmonary artery pressure monitoring catheter and who made us know their mixed venous oxygen condition. We found that there was no close relationship between MVPO2 and Cardiac Index [C.I.] during early postoperative period, but on the first and second day after operation the correlation coefficient was increased as r=0.35[p=0.008], r=0.78[p=0.0001]. So we concluded that the correlation between MVPO2 and C.I. was more reliable with time going as hemodynamic stabilization. And we experienced no survivors whose MVPO2 was under 20 torr, but that was not the only factor for death. From these results, we conclude that we can consider the MVPO2 [or MVSO2] representing C.I. after stabilized postoperative condition of the open heart surgery patients, but during early postoperative period, in addition to this MVPO2, we should do also apply other parameter such as urine output, arterial blood pressure, left atrial pressure and pulmonary arterial pressure for exact estimation of the patients status.

• Korean Journal of Veterinary Research
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• v.40 no.4
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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 Yeungnam Medical Science
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• v.2 no.1
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• pp.241-247
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• 1985

Bacterial endocarditis has been well recognized as an important complication of congenital heart disease, such as ventricular septal defect, patent ductus arteriosus or pulmonary stenosis. The incidence of right sided bacterial endocarditis is lesser than left sided bacterial endocarditis. Also, pulmonic valve vegetation has been thought to be relatively uncommon. And pulmonary embolism is common in the patients with right sided bacterial endocarditis. So in a patient with fever and evidence of recurrent pulmonary infarction, changing heart murmurs and scattered pneumonic infiltrates, one should direct attention to the heart as a possible source of the infection. Echocardiography with M-mode, 2-D and Doppler mode represents the only noninvasive technic available for detecting vegetations in bacterial endocarditis. In fact, the technic is more sensitive in identifying these lesions than angiography. We experienced a case of ventricular septal defect with bacterial endocarditis, pulmonic valve vegetation and multiple pulmonary embolism diagnosed with Echocardiogram and lung scan, and confirmed by operation. Patch repair of ventricular septal defect, resection of pulmonic valve and vegetation and artificial valve formation with pericardium were done.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.64-67
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• 2002

Eisenmenger's syndrome is the disease of right to left shunt developing from the increased pulmonary vascular resistance caused by excessive pulmonary blood flow in patients with abnormal connections of systemic to pulmonary blood passage. The heart-lung transplantation was the only curative method in early transplantation period, but good results after bilateral lung transplantation have been reported as the fact that right heart function improved by only lung transplantation. We successfully carried out bilateral sequential single lung transplantation in a 34-year-old female patient with Eisenmenger's syndrome with large PDA. We report this case with a brief review of the literature.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.371-380
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• 1984

Corrected transposition of the great arteries [C-TGA] is one of the rare congenital heart disease in which there is both a discordant atrioventricular relationship and transposition of the great vessels. With this arrangement, systemic venous blood passes through the right atrium into the morphologic left ventricle and out the pulmonary artery. Pulmonary venous blood returns to the left atrium, flows into the morphologic right ventricle and out the aorta. Thus, in the rare case when no additional cardiac anomaly is present, a hemodynamically normal heart exists. But more often they are symptomatic as a result of one or several of the commonly associated defects. This paper describes 13 patients who underwent repair of one or more cardiac anomalies associated with corrected transposition at SN UH, from June 1976 through June 1984. 1.8 were males and 5 females, with ages ranging from 3 years to 27 years. 2. Segmental anatomy was {S,L,L} in 12, or {I,D,D} in 1. 3.Associated anomalies were ventricular septal defect in 10, pulmonary outflow tract obstruction in 6, tricuspid insufficiency in. 4, atrial septal defect in 3, subaortic stenosis in 1, mitral insufficiency in 1, and patent ductus arteriosus in 1. 4.None had complete heart block preoperatively, and 3 developed complete heart block intraoperatively. But one of them recovered sinus rhythm on the postoperative 7th day spontaneously. 5.There were 3 cases of hospital morality. But there was no morality since Dec. 1980. 6.Patients with single ventricle, hypoplastic ventricle or those who had palliative surgery alone are not included in this review.

• Journal of Veterinary Clinics
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• v.31 no.4
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• pp.325-328
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• 2014

A 8-month-old female Maltese dog was presented with a history of heart murmur. In physical examination, grade 4/6 systolic murmur heard at the left heart base. Electrocardiography showed sinus arrhythmia, right axis deviation, deep S wave and splintered QRS complex. Thoracic radiography revealed enlarged right side heart and bulging of the main pulmonary artery. Echocardiography showed mild hypertrophy of right ventricle, a supravalvular stenosis, marked post-stenotic dilation of the main pulmonary artery and a moderately increased pulmonary arterial velocity through the stenotic area (4.4 m/s, pressure gradient of 78.7 mmHg). The dog was diagnosed with supravalvular pulmonic stenosis based on the diagnostic imaging findings. Medical management using ${\beta}1$-blocker and ACE inhibitor was started in this dog and this is first case report described diagnostic characteristic features of supravalvular pulmonic stenosis in korea.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.957-969
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• 1988

There is tendency of increasing number and decreasing age of patients who are indicated for Rastelli operation for their cyanotic congenita heart disease. So there is the need to find the creiterion which saves the patients from early postoperative hemodynamic disturbances. We reviewed the 26 patients who had been performed Rastelli operation at Seoul national University hOipital from January 1981 to June 1988. mean age of the patients was 7.8 $\pm$ 3.4 years (range 2.5-1.5 years), mean body surface area(BSA) 0.79 $\pm$ 0.25 $m^{2}$(range 0.49-1.51 $m^{2}$) and mean hematocrit 57.95 $\pm$ 12%(range 48-80%). We diveded these patients into survived group and died group before postoperative 72 hours, and analysed preoperative arterial oxygen saturation($SaO_{2}$), the ratio of diameter of fight pulmonary artery to ascending aorta(RA:/AA), the ratio of both right and left pulmonary artery diameter to descending thoracic aorta(RPA+LPA/DTA), pulmonary artery index(PA index), cardiopulmonary bypass time, aorta cross-clamping time, postoperative perfusion state and total amount of dopamine infused postoperatively. The results showed that RPA+LPA/DTA and PA index were statistically significatn factors to influence early postoperative cardiac death rate (P<0.05). Especially there were good linear correlations between PA index(X) and perpheral perfusion index(Y)(Y = -1.15 + 0.02 X, r = 0.86, P<0.01) and between PA index(X) and total amount of dopamine infused before postoperative 72 hours(mg/kg, Y)(Y = 61.94 - 0.15 X, r = - 0.80, P<0.01). Also there were tendencies that the higher RPA + LPA/DTA(Y), the betterperipheral perfusion (X) and the lower need of dopamine(X), but no statistical significance. (Y = 0.78 + 1.60 X, r = 0.49, P>0.05) And the discrimant analysis showed that patients with PA index over 221 $mm^{2}$/BSA could undergo correction with 25 per cent of error rate. In conclusion, early postoperative hemodynamic states could be predicted by preoperatively measured PA index, and which can be used as a criterion for Rastelli operation performed on cyanotic congenital heart disease.