• Journal of Chest Surgery
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• v.23 no.4
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• pp.640-645
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• 1990

We have performed four left lung reimplantation and right pulmonary artery ligation in dogs for six months from March 1989 to September 1989 at the Thoracic & Cardiovascular Surgery department, Yonsei University, College of Medicine, Seoul, Korea. Excised left lungs were perfused with 200cc of 4oC cold saline at a pressure of 60cmH2O through left pulmonary artery & preserved in 4 oC cold saline for about 20 mins. Left lung reimplantation were proceeded with inferior pulmonary vein, superior pulmonary vein, left pulmonary artery and left main bronchus in order. The main pulmonary artery pr. were 39/21[31], 22/12[15], 25/9[15] and 54/17[37] mmHg each after right pulmonary artery ligation on left reimplanted dogs, Right pul a. ligations were performed 9 days, 12 days, 16 days and 19 days after left lung reimplantation. Two dogs died at 10 days 21 days, after right pul. a. ligations in left reimplanted dogs. The remaining two dogs were sacrificed at 18 days, 21 days after right pul. a. ligation in left reimplanted dogs. Autopsy findings showed narrowing of left superior pul. vein anastomotic site in two narrowing of left pulmonary artery anastomotic site in one narrowing of left sup. pul vein & pneumonia of left lung in one. In the lung transplantation, it was thought to be important that the anastomosis of pulmonary artery and especially pulmonary vein be done with particular precaution for early and late stenosis.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.63-68
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• 1973

Two patients operated upon for tricuspid atresia by Glenn operation are presented. They were five years old and four years old females who were cyanotic shortly after birth, and remained cyanotic. On physical examination, cyanosis on digits and lips, clubbing of fingers, thrill and grade III systolic murmur on 4th I.C.S. along left sternal border were noted. In the first case, chest roentgenograms showed normal pulmonary markings, and the electrocardiogram was interpreted as showing left ventricular hypertrophy with left axis deviation and peaked P-wave in lead IL Right heart catheterization showed high pressure in right atrium and the catheter tip was easily inserted into the left atrium through septal defect. In the second case, chest roentgenograms showed cardiomegaly with sparse pulmonary vascular markings and narrowed vascular pedicle, and the electrocardiogram showed left ventricular hypertrophy with some element of right atrial hypertrophy. Angiocardiogram showed changes characteristic of tricuspid atresia, including "right ventricular window" The findings of right heart catheterization were similar to those of first case. On the basis of these observations, they were diagnosed as tricuspid atresia, and Glenn operation was performed. Normal position of great vessels combined with ventricular septal defect and pulmonary stenosis were noted on the first case, and on second case, transposition of great vessels was additional finding. Postoperative course was uneventful and favorable outcome was obtained.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.277-280
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• 2015

We report the case of a 37-year-old man who suffered from biventricular failure due to left isomerism, inferior vena cava interruption with azygos vein continuation, bilateral superior vena cava, double outlet of right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and isolated dextrocardia. Heart transplantation in patients with systemic venous anomalies often requires the correction and reconstruction of the upper & lower venous drainage. We present a case of heart transplantation in a patient with left isomerism, highlighting technical modifications to the procedure, including the unifocalization of the caval veins and reconstruction with patch augmentation.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.114-118
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• 2017

Kimura disease (KD) is an immune-mediated chronic inflammatory disease of unknown etiology. KD has many complications associated with hypereosinophilia, including various forms of allergic reactions and eosinophilic lung disease. Additionally, hypereosinophilia is associated with hypercoagulability, which may lead to thromboembolic events. A 36-year-old man with KD presented with acute limb ischemia and coronary artery occlusion. He underwent thrombectomy, partial endarterectomy of both popliteal arteries, and coronary artery stent insertion. KD is a systemic disease that affects many organs and presents with thromboembolism and vasculitis. In a patient with KD, physicians should evaluate the vascular system, including the coronary arteries.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.1
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• pp.31-35
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• 2012

Noonan syndrome is characterized by short stature, typical facial dysmorphology, and congenital heart defects. The main facial features of Noonan syndrome are hypertelorism with down-slanting palpebral fissures, ptosis, and low-set posteriorly-rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency, and lymphatic dysplasias. The patient is a 10-year-old boy. He had experienced repeated febrile convulsions. He had typical facial features, a short stature, chest deformity, cryptorchidism, vesicoureteral reflux, and mental retardation. His language and motor development were delayed. When he went to school, it was difficult for him to pay attention, follow directions, and organize tasks. He also displayed behavior such as squirming, leaving his seat in class, and running around inappropriately. Clinical observation is important for the diagnosis, so we report a patient who was diagnosed with Noonan syndrome, mental retardation, and attention-deficit hyperactivity disorder.

• Advances in pediatric surgery
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• v.17 no.1
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• pp.72-80
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• 2011

Although laparoscopic surgery for hepatobiliary disease in children is possible, it is technically challenging. In an attempt to overcome these difficulties, the da Vinci Robotic Surgical System$^{(R)}$ was used to facilitate the minimally invasive treatment of choledochal Cyst in six children. In early consecutive three cases, we experienced three complications; a case of laparotomy conversion, a case of late stenosis of the hepaticojejunostomy, and a case of leakage from a hepaticojejunostomy. However, in the last three cases the complete resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy were performed using the robotic surgical system without complication. We think robot-assisted choledochal cyst resection in children appears safe and feasible, and may increase the variety of complex procedures in pediatric surgical fields.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1651-1654
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• 2008

Previous reports have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissures not directly involved in the pathologic process. However, bio-mechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligament are preserved. Therefore the aim of this study is to evaluate the bio-mechanical properties after spinous process osteotomiy, using finite element analysis. In the model of spinous process osteotomy the increase of stress in the disc and segmental rangesof motions were not changed significantly. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, these osotetomy was considered to be a clinicallysafe surgical procedure and could not cause the instability of patient.

• The Journal of Pediatrics of Korean Medicine
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• v.14 no.2
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• pp.141-147
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• 2000

Moyamoya is a chronic cerebrovascular disease chracterized by progressive stenosis or occlusion of the terminal parts of both internal carotid arteries with telangiectatic vascular network of collateral circuration at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. The clinical course in those whose first symptoms occur in childhood is different from those in whom symptoms develop in adult life. The term moyamoya disease should be resserved for those cases in which the chracteristic angiographic pattern is idiopathic; moayamoya syndrome is used when the underlying condition is known. we have experienced a case of moyamoya syndrome in a 5-year-2-month-old boy who presented right-sided hemiparesis. A cerebral angiogram revealed occlusion of abnomal collateral network. Moyamoya disease is applicable to stroke of an infant from oriental medicine point of view, and The symptoms is similar to adult stroke, we have treated adult stroke patint with herb medicine and acupuncutre and physical treatment. The acute stage of stroke is applied to the external treatment(標治), and The recovery stage is applied to the basic treament(本治).

• Clinical and Experimental Pediatrics
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• v.57 no.1
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• pp.19-25
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• 2014

Recently, surgical outcomes of repair of tetralogy of Fallot (TOF) have improved. For patients with TOF older than 3 months, primary repair has been advocated regardless of symptoms. However, a surgical approach to symptomatic TOF in neonates or very young infants remains elusive. Traditionally, there have been two surgical options for these patients: primary repair versus an initial aortopulmonary shunt followed by repair. Early primary repair provides several advantages, including avoidance of shunt-related complications, early relief of hypoxia, promotion of normal lung development, avoidance of ventricular hypertrophy and fibrosis, and psychological comfort to the family. Because of advances in cardiopulmonary bypass techniques and accumulated experience in neonatal cardiac surgery, primary repair in neonates with TOF has been performed with excellent early outcomes (early mortality<5%), which may be superior to the outcomes of aortopulmonary shunting. A remaining question regarding surgical options is whether shunts can preserve the pulmonary valve annulus for TOF neonates with pulmonary stenosis. Symptomatic neonates and older infants have different anatomies of right ventricular outflow tract (RVOT) obstructions, which in neonates are nearly always caused by a hypoplastic pulmonary valve annulus instead of infundibular obstruction. Therefore, a shunt is less likely to preserve the pulmonary valve annulus than is primary repair. Primary repair of TOF can be performed safely in most symptomatic neonates. Patients who have had primary repair should be closely followed up to evaluate the RVOT pathology and right ventricular function.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.84-87
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• 2016

Midaortic syndrome (MAS) is a rare vascular disease that commonly causes renovascular hypertension. The lumen of the abdominal aorta narrows and the ostia of the branches show stenosis. MAS is associated with diminished pulses in the lower extremities compared with the upper extremities, severe hypertension with higher blood pressure in the upper rather than lower extremities, and an abdominal bruit. The clinical symptoms are variable, and recognition in children with hypertension can aid early diagnosis and optimal treatment. Hypertension with MAS is malignant and often refractory to several antihypertensive drugs. Recently, radiologic modalities have been developed and have led to numerous interventional procedures. We describe the case of a 3-year-old boy presenting with left ventricular hypertrophy whose severely elevated blood pressure led to the diagnosis of idiopathic MAS. This case highlights the importance of measuring blood pressure and conducting a detailed physical examination to diagnose MAS. This is the first reported case of idiopathic MAS diagnosed in childhood in Korea.