• 제목/요약/키워드: Situs

검색결과 48건 처리시간 0.019초

좌심방 양심실 연결증 [DOLA] (Double Outlet Left Atrium: A rare form of the atrioventricular septal defect with malposition of the atrial septum)

  • 이재원;서경필
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.273-278
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    • 1985
  • The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

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Ebstein 심기형 수술 1례[Plication 및 삼첨판막 이식예] (Ebstein`S Anomaly: A Case Report of Plication and Tricuspid Valve Replacement)

  • 송명근
    • Journal of Chest Surgery
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    • 제11권3호
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    • pp.342-347
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    • 1978
  • A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

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총동맥간 잔류증 [IV 형]Rastelli 수술 치험 보고 (Rastelli operation in Persistent Truncus Arteriosus, Type IV: A Case Report)

  • 김형묵
    • Journal of Chest Surgery
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    • 제11권3호
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    • pp.333-341
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    • 1978
  • A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

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심실중격결손, 심방중격결손, 폐동맥협착과 우심증을 동반한 완전대혈관전위증의 치험 (A successful Mustard operation for complete transposition of the great arteries combined with VSD, ASD, dextrocardia and PS: a report of one case)

  • 조중구
    • Journal of Chest Surgery
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    • 제15권3호
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    • pp.346-354
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    • 1982
  • A Complete transposition of the great arteries combined with V.S.D, A.S.D, dextrocardia, and P.S is a rare congenital anomaly. The patient was a 10 year-old female whose complaints were frequent URI, exertional dyspnea, and cyanosis at rest since birth. Cheat X-ray films showed Dextrocardia ; situs inversus, moderate cardiomegaly, and Characteristic egg-shape heart shadow. E.K.G, Echocardiography, Cardiac Catheterization, and Angio-Cardiography were performed. Open heart Surgery was done under diagnosis of d-TGA, Dextrocardia, V.S.D, A.S.D, and P.S. At the time of Operation, Dextroeardia, T.G.A, Secndum type A.S.D, A.S.D, and P.S. At the time of Operation, Dextroeardia, T.G.A, Secndum type A.S.D. ($2.0{\times}2.0cm$. in diameter), V.S.D. type II ($1.5cm{\times}1.5cm$ in diameter), and pulmonary valvular stenosis were noted. Mustard operation using pericardial Baffle in the atrium for T.G.A. was perforsned. Teflon patch graft for closure of V.S.D. through tricuspid orifice and pulmonary Valvulotomy through pulmonary arteriotomy were performed. The post-op, low cardiac output Syndrome and dysrhythmicawere developed till Postoperative day #7, so that was controlled by inotropic and antiarrhythmic agents. After that, patient's conditions were Uneventful.

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삼첨판막 폐쇄부전을 동반한 선천성 교정형 대혈관전위증치험 1례 보 (Corrected transposition of the great arteries associated with severe tricuspid insufficiency: one case report)

  • 김치경;나범환;이홍균
    • Journal of Chest Surgery
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    • 제17권3호
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    • pp.362-370
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    • 1984
  • The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.

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십자형심장에 동반된 양대혈관우심실기시증 -수술치험 1례 (Double Outlet of Right Ventricle in Criss-Cross Heart -Surgical Experience of One Case)

  • 김대연;조성래;박성달;정현기
    • Journal of Chest Surgery
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    • 제30권12호
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    • pp.1242-1246
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    • 1997
  • Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in priss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solidus, concordant atrioventricular connection and double outlet of rig t ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 314 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.

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$^{99m}Technetium$-가열처리 적혈구에 의한 비장스캔 ([ $^{99m}Technetium-Heat$ ] Damaged Erythrocyte Spleen Scan)

  • 최창운;박석건;정준기;이명철;조보연;고창순;정순일
    • 대한핵의학회지
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    • 제20권1호
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    • pp.39-43
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    • 1986
  • [ $^{99m}Technetium-Heat$ ] damaged erythrocyte were used as spleen scanning agents in 12 patients from July, 1985 to April, 1986. We used this scan to evaluate situs inversus, asplenia, accessory spleen, hypersplenism, splenic infarction, tumor staging and evaluation of therapy, especially when the $^{99m}Tc-tin$ colloid scans were not definite for diagnosis. The techniques applied to these scans were in vivo/in vitro-labeling method and heating-method to damage the erythrocytes. Liver-to-spleen uptake ratios were increased upto 100 : 1 and interference from the left lobe of the liver was eliminated. These scans were helpful to evaluate the spleen.

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Congenital Heart Disease: a Pictorial Illustration of Putting Segmental Approach into Practice

  • Yeung, Tse Hang;Park, Eun-Ah;Lee, Ying Cheong;Yoo, Jin Young;Lui, Choi Yu
    • Investigative Magnetic Resonance Imaging
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    • 제19권4호
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    • pp.205-211
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    • 2015
  • The human heart is a complex organ in which many complicated congenital defects may happen and some of them require surgical intervention. Due to the vast complexity of varied anatomical presentations, establishing an accurate and consistent nomenclature system is utmost important to facilitate effective communication among pediatric cardiologists, cardiothoracic surgeons and radiologists. The Van Praagh segmental approach to the complex congenital heart disease (CHD) was developed in the 1960s and has been used widely as the language for describing complex anatomy of CHD over the decades. It utilizes a systematic and sequential method to describe the cardiac segments and connections which in turn allows accurate, comprehensive and unambiguous description of CHD. It can also be applied to multiple imaging modalities such as echocardiogram, cardiac CT and MRI. The Van Praagh notation demonstrates a group of three letters, with each letter representative for a key embryologic region of cardiac anatomy: the atria, ventricles and great vessels. By using a 3-steps approach, we can evaluate complex CHD precisely and have no difficulties in communicating with other medial colleague. This pictorial essay revisits the logical steps of segmental approach, followed by a pictorial illustration of its application.

Alagille 증후군 1례 (A Case of Alagille Syndrome)

  • 김은수;이동우;정기섭;김순일;박영년
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제5권2호
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    • pp.192-198
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    • 2002
  • 저자들은 지속적인 황달을 주소로 연세의대 세브란스병원에 입원하였던 10개월 된 남아에서 특징적인 얼굴모양, 심혈관계 이상, 간 생검 조직검사상 담즙 정체, 거대세포 형성 및 소염관 담관의 수가 감소되어 있었고, 퇴원 후 간경변으로 이행되어 간 이식수술을 받았던 Alagille증후군 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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선박건조자의 책임과 제조물책임에 관한 연구 (A Study on the Liability of the Builder in the Shipbuilding Contract and Products Liability)

  • 정선철
    • 한국항해항만학회:학술대회논문집
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    • 한국항해항만학회 2006년도 추계학술대회 논문집(제2권)
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    • pp.21-26
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    • 2006
  • 선박건조계약은 일반적으로 각 당사자의 권리와 의무 및 상대방에 대한 책임 등에 대하여 내용이 상당히 복잡하고 구체적으로 규정되며, 계약의 최종 목적은 선박 건조자가 완성된 선박을 매수인인 선주에게 이전하는 것이다. 이 계약은 영국법, 미국법, 개정독일민법(BGB), 그리고 기타 여러국가의 법에서 매매계약으로 보고 있으며, 반면에 한국과 일본 그밖의 여러국가에서는 도급계약으로 취급한다. 특별히 최근 여러 국가에서 안전상 사람에 대하여 상해를 일으킨 경우, 불법행위에 의한 제조자의 제조물책임이 잘 정착되어 있는 실정이다. 반면, 제3자에 대한 순수 경계적인 손실에 대해서는 그 물건의 소유자에게 그 책임이 확대되었다. 해사사건에 있어서 계약상 워런티나 묵시적인 워런티를 위반한 경우, 사건의 장소나 전통적인 해사 관련성에 의하여 해사재판관할권이 적용되어 진다. 즉 물품의 하자와 관련된 사건인 경우, 계약법상 워런티가 첫째 유형으로 적용되고, 불법행위에 의한 것은 두 번째 유형으로 적용된다. 그러므로 본 논문에서는 먼저 선박건조계약상 건조자의 계약책임에 대하여 영국법을 중심으로 고찰하고 다음으로 영국, 미국, 독일, 그리고 한국의 제조물책임법을 비교하여 결론적으로 각국들의 제조물책임에 대한 한국 조선소들의 대응전략을 제시함을 본 논문의 목적으로 한다

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