• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.429-431
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• 2007

Although the ventriculo-peritoneal shunt is the treatment of choice when hydrocephalus should be corrected, the ventriculo-atrial shunt still holds strong alternative when the peritonium is precluded due to the several reasons. During the ventriculo-atrial shunt operation, it is not always easy to dissect and find the corresponding venous structures. In this technical note, the author describes a simple method of percutaneous insertion for placement of the atrial end.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.268-273
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• 1977

During the period from March, 1963, to November, 1977, forty-eight patients with secundum type atrial septal defects have undergone surgical repair using cardiopulmonary bypass with a pump oxygenator at the Seoul National University Hospital. Twenty-six [55 percent] of the patients were females and Twenty-two [45 percent] were males. The patients varied in age from 3 years to 51 years. We have divided secundum defects into three types. These are: 1] the high defect; 2] Ovale type defect; and 3] low defect including the defect in the area of the coronary sinus. An ovale type defect was present in forty-one cases [85 percent]. Partial anomalous pulmonary venous connections were present in two patients in the high defect group. All of the forty-eight patients had had right heart catheterization before operation. The pulmonary to systemic flow ratio [Qp/Qs] was determined in our 38 patients. The Qp/Qs was less than 1.5/1 in only five of the 38 patients. Among the 33 patients with moderate and severe left-to-right shunts [Qp/Qs 1.6-3.5/1], the systolic pulmonary artery pressures. ranged from 30 to 80 mm Hg. Large left-to-right shunts [Qp/Qs>3.6/1] were present in 13 patients. The postoperative complications occurred in 13 patients [27. 1 percent]. Postoperative wound infections were the most frequent complications being present in 6 patients [12.5%]. Forty-six of the patients with secundum atrial septal defects survived surgical repair of their defects. Thus the hospital mortality of surgery was 4.2 percent. The causes of death in the early postoperative period were: 1] low cardiac output syndrome related to severe pulmonary hypertension in one case; and 2] postoperative several bleeding in one case.

• The Korean Journal of Nuclear Medicine
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• v.18 no.1
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• pp.9-17
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• 1984

The purpose of this study is to investigate significance of new method for quantification of left to right cardiac shunts using deconvolution analysis as an adjunct to gamma variate analysis in patients with bad bolus injection. In the present study, quantitative radionuclide angiocardiography (QRAC) was performed with and without deconvolution analysis (DA) in 37 patients with left to right shunt and 103 control patients without shunt. The results obtained were as follows; 1) The mean value of $Q_p/Q_s$ in 103 control patients was $1.10{\pm}0.12$ without DA, and was $1.01{\pm}0.03$ with DA. 2) Correlation(r) between oximetry and QRAC with DA was 0.87 and correlation(r) between oximetry and QRAC without DA was 0.61. 3) The 13 patients with left to right shunt, whose $Q_p/Q_s$ was greater than 3.0 by QRAC without DA, was studied by DA. Then the $Q_p/Q_s$ values were measurable in these 13 patients by DA and they showed significant correlation with oximetry. (r=0.68) The results indicate that deconvolution analysis technique for quantification of a left to right shunt provides more reliable and accurate shunt quantification, and reduces the influences of poor bolus injection.

• Progress in Superconductivity
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• v.10 no.1
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• pp.45-49
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• 2008

For the development of superconducting fault current limiters (SFCLs), fault current limiting elements were fabricated out of Bi-2212 bulk tubes and tested. The SFCL elements consisted of tube shaped Bi-2212 bulks and metal shunts for the stabilizers. Firstly, the Bi-2212 bulk tubes were processed based on a design of monofilar coils in order to acquire large resistance and high voltage rating. 300 mm-long Bi-2212 tubes were designed to have the current path of 410 cm in length with 24 turns and 41 mm in diameter. The processed monofilar coil, as designed, had 300 A $I_c$ at 77 K. The fabricated superconducting monofilar coils were affixed to Cu-Ni alloy as that of stabilizers. The Cu-Ni alloys were processed to have the same shape of the superconducting monofilar coils. The Cu-Ni coil had resistivity of 32 ${\mu}{\Omega}$-cm at 77 K and 37 ${\mu}{\Omega}$-cm at 300 K. The metal shunts were attached to the outside of the Bi-2212 monofilar coil by a soldering technique. After the terminals made of copper were attached to both ends of the superconductor-metal shunt composite, the gap between the turns and the surface of the elements was filled with an epoxy and a dense mesh made of FRP in order to enhance the mechanical strength. The completed SFCL elements went through fault tests, and we confirmed that the voltage rating of 143 $V_{rms}$ (E =0.35 $V_{rms}$/cm) could be accomplished.

• Journal of Chest Surgery
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• v.45 no.2
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• pp.95-100
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• 2012

Background: The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. Materials and Methods: Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, $67.2{\pm}9.4$ years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. Results: During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was $59.1{\pm}10.3$ minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. Conclusion: Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

• The Korean Journal of Nuclear Medicine
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• v.20 no.1
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• pp.85-91
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• 1986

In detecting, localizing and quantitating cardiac shunts, radionulide angiocardiography has been known to be a simple and safe method compared with oxymetry method. To ascertain the availability of the results obtained by radionuclide angiocardiography for the evaluation of patients with cardiac shunt, author compared the Qp/Qs ratios(pulmonary to systemic flow ratios) obtained by radionuclide angiocardiography with the results of oximetry method in 40 patients with left to right shunt, and also compared the results of radionuclide angiocardiography examined before and after shunt operation in 8 patients. The results were as follows: 1) Of the 161 patients examined radionuclide angiocardiography, 98 were thought to have cardiac shunts: right to left shunt id 27, left to right shunt in 71. Of the 71 patients who had left to right shunt, 40 who were examined with both radionuclide angiocardiography and oxymetry had following congenital heart disease: VSD in 21, ASD in 9 and PDA in 10. 2) Comparison of Qp/Qs ratios obtained during radionuclide angiocardiography and oxymetry revealed good correlation (linear regression analysis yielded correlation coefficient of 0.80) in 32 patients whose Qp/Qs ratio obtained during oxymetry were below 3.0, but very poor correlation in 8 patients whose Qp/Qs ratios were above 3.0 3) Radionuclide angiocardiography is a relatively safe and simple method in postoperative evaluation of patients with cardiac shunt.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.50-57
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• 1986

Sixty-nine patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] prosthesis between 1979 and 1985. Their ages ranged from 2 months to 39 years [mean$\pm$SD: 5.2$\pm$7.4, median: 3.3 years]. Diagnosis included the following: Tetralogy of Fallot, 45: Double outlet right or left ventricle, 11: Single ventricle, .5: Transposition of great vessels, 4: Tricuspid atresia, 3 and Pulmonary atresia with intact ventricular septum, 1. Forty-eight patients had subclavian-pulmonary artery anastomosis, 12 patients aorta-right pulmonary artery anastomosis, 6 patients aorta-main pulmonary artery anastomosis, and 3 patients descending aorta-pulmonary artery anastomosis. The PTEE graft of 3 mm in diameter was used in 1, 4 mm in 29, 5 mm in 35 and 6 mm in 4 patients. Ten patients were died within 30 days after operation [mortality rate: 14.5%]. Among them, 6 patients were operated in urgency due to cardiac arrest or severe anoxic spell after cardiac catheterization, and so surgical mortality of elective operation is 9.5%. The 59 survivors showed improvement of the arterial oxygen saturation [65.4% - 9.8%] and hemoglobin [18.8 gm/dl - 16.0 gm/dl] values [V<0.01]. The follow up period ranged from 1 month to 67 months, [752 patient-months] and during this periods there were 4 late shunt failures after 3 months postoperatively with 4 mm graft, and 2 with 5 mm graft. The over-all patency rate of 4 mm PTFE was 85.9$\pm$9.2% [SEM] in 12 months and 40.9$\pm$22.5% in 24 months. The over-all patency rate of 5 mm PTFE was 87.5$\pm$9.6% in 12 months and 58.3$\pm$24.6% in 36 months. The lowest systolic pressure in death group was 64.9$\pm$15.0 mmHg and in survival group, 86.4$\pm$12.1 mmHg [P<0.001]. We think that the PTFE graft is useful in palliative shunt operation, but the effectiveness of the 4 mm PTFE graft may be limited. The blood pressure also may play an important role in patency of Prosthesis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.273-278
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• 2021

Purpose: Percutaneous endoscopic gastrostomy (PEG) is a safe method to feed patients with feeding difficulty. This study aimed to compare the outcomes of conventional PEG and laparoscopic-assisted PEG (L-PEG) placement in high-risk pediatric patients. Methods: In our tertiary pediatric department, 90 PEG insertions were performed between 2014 and 2019. Children with severe thoracoabdominal deformity (TAD), previous abdominal surgery, ventriculoperitoneal (VP) shunt, and abdominal tumors were considered as high-risk patients. Age, sex, diagnosis, operative time, complications, and mortality were compared among patients who underwent conventional PEG placement (first group) and those who underwent L-PEG placement (second group). Results: We analyzed the outcomes of conventional PEG placement (first group, n=15; patients with severe TAD [n=7], abdominal tumor [n=6], and VP shunts [n=2]) and L-PEG placement (second group, n=10; patients with VP shunts [n=5], previous abdominal surgery [n=4], and severe TAD [n=1]). Regarding minor complications, 1 (6.6%) patient in the first group underwent unplanned PEG removal and 1 (10%) patient in the second group had peristomal granuloma. We observed three major complications: colon perforation (6.6%) in a patient with VP shunt, gastrocolic fistula (6.6%) in a patient with Fallot-tetralogy and severe TAD, and pneumoperitoneum (6.6%) caused by early tube dislodgement in an autistic patient with severe TAD. All the three complications occurred in the first group (20%). No major complications occurred in the second group. Conclusion: In high-risk patients, L-PEG may be safer than conventional PEG. Thus, L-PEG is recommended for high-risk patients.

• Korean Journal of Veterinary Research
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• v.48 no.1
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• pp.99-103
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• 2008

A 2-month-old female Abyssinian cat was presented with a severe ascites, cyanosis, and exercise intolerance. Diagnostic studies revealed V/VI holosystolic murmur, sinus tachycardia, generalized cardiomegaly with marked left atrial enlargement and shunt flow between left and right ventricles. Doppler study showed bi-directional shunts in rest and right-to-left shunt after exercise. Based on clinical signs and diagnostic findings, the cat was diagnosed as a reversed ventricular septal defect. The cat was treated with furosemide, nitroglycerine, dobutamine and oxygen supplement. Despite initial improvement of clinical signs after initiation of medical treatment, the cat died of sudden cardiac arrest. Necropsy revealed a perimembranous ventricular septal defect.

• Korean Journal of Veterinary Research
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• v.48 no.4
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• pp.493-500
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• 2008

A 2-year-old female Pekingese dog was presented with primary complaints including exercise intolerance and neurological sign associated with hepatic encephalopathy. The major findings in clinical examination included an intermittent seizure, a slow heart rate with pulse deficit, leukocytosis and anemia in hemogram, elevated pre- and post-prandial serum bile acid and hepatic enzymes, hypoproteinemia, coagulopathy, ammonium urate crystaluria and bilirubinuria. Diagnostic tests revealed an intrahepatic portosystemic shunt complicated with a second degree atrioventricular block and QT prolongation. The case was successfully treated with a transvenous coil embolization. Clinical signs were gradually improved and cardiac bradyarrhythmia disappeared. This case is a rare case of intrahepatic portosystemic shunts complicated with a cardiac bradyarrhythmia in a small breed dog fixed by a transvenous coil embolization.