• IMMUNE NETWORK
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• v.21 no.2
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• pp.17.1-17.10
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• 2021

Abdominal aortic aneurysm (AAA) is a chronic dilation of the aorta with a tendency to enlarge and eventually rupture, which constitutes a major cause of cardiovascular mortality. Although T-cell infiltrates have been observed in AAA, the cellular, phenotypic, and functional characteristics of these tissue-infiltrating T cells are not fully understood. Here, we investigated the proportional changes of T-cell subsets-including CD4⁺ T cells, CD8⁺ T cells, and γδ T cells-and their effector functions in AAAs. We found that Vδ2⁺ T cells were presented at a higher frequency in aortic aneurysmal tissue compared to normal aortic tissue and PBMCs from patients with AAA. In contrast, no differences were observed in the frequencies of CD4⁺, CD8⁺, and Vδ1⁺ T cells. Moreover, we observed that the Vδ2⁺ T cells from AAA tissue displayed immunophenotypes indicative of CCR5⁺ non-exhausted effector memory cells, with a decreased proportion of CD16⁺ cells. Finally, we found that these Vδ2⁺ T cells were the main source of IL-17A in abdominal aortic aneurysmal tissue. In conclusion, our results suggest that increased Vδ2⁺ T cells that robustly produce IL-17A in aortic aneurysmal tissue may contribute to AAA pathogenesis and progression.

• Journal of Trauma and Injury
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• v.18 no.1
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• pp.70-79
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• 2005

Background: Abdominal compartment syndrome has multiple etiologies that are not only related to trauma but also any problem condition in the absence of abdominal injury. To determine whether prevention of the abdominal compartment syndrome after celiotomy for trauma victims justifies the use of temporary abdominal coverage with monofilament knitted polypropylene mesh (Malex mesh) in severely injured patients. Method: Medical records at the Ajou University Medical Center were reviewed for a 32-month period from May 1st, 2002 to December 31st, 2004. Twenty-nine consecutive patients requiring celiotomy who were survived until at the end of celiotomy received temporary abdominal coverage and staged abdominal repairs with Malex mesh. One of them was dissecting aortic aneurysm patient and the others were all trauma victims. Malex mesh prosthesis coverage was used in cases of abdominal compartment syndrome due to excessive fascial tension, severe bowel edema and retroperitoneal hemorrhage or edema followed by staged abdominal repairs. Result: Eighteen of twenty-nine patients were survived. Demographic characteristics, injury severity number of abdominal-pelvic bone injuries, mortality rate, complications, number of operations for permanent closure, required time for permanent closure showed no difference between man and women or child and adult. Except one dissecting aortic aneurysm patient, trauma cases showed $3.24{\pm}0.98$ injury sites. All cases that received temporary abdominal coverage and staged abdominal repairs did not show abdominal compartment syndrome. $10.08{\pm}5.85$ days and $2.27{\pm}0.82$ times of operation required making permanent abdominal closure after temporary abdominal coverage followed by staged abdominal repairs. Most of surviving patients have shown antibiotic-resistant organism and fungus infection. Patients who received permanent closure recovered from infectious problem completely. Conclusion: The use of Malex mesh for temporary abdominal coverage in severely injured patients undergoing celiotomy was effective treatment method.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.300-307
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• 1997

We have experienced 25 cases of aortic aneurysm from October 1987 to January 1996. Patients ranged in age from 26yrs to 73yrs(mean age 52. Syrs). There were 13 males and 12 females. Eighteen cases were thoracic aneurysm and seven were abdom nal aneurysm. The cause of aneurysm were dissecting in 16cases aneurysms and non-dissecting in 9 cases. Risk factors of aortic aneurysm were hypertension, hypercholesterolemia, Marfan's syndrome. In thoracic aneurysm patients, 1'S cases of dissecting aneurysm underwent aneurysmectomy and replacement of vessel interposition graft with or without coronary artery implantation on the graft. 6 cases of non-dissecting aneurysm underwent operation with same policy as dissecting aneurysm. In 7 case of abdominal aneurysm,all patients underwent aneurysmectomy and graft interposition with straight i)r Y graft. Thcre were 5 postoperative death(mortality 20%). Several cases of complications were improved with proper managements. All survivors showed improvement in clinical symptom and sign and discharged without specific complications.

• International Journal of Vascular Biomedical Engineering
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• v.2 no.2
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• pp.10-15
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• 2004

Purpose: In the treatment of aortic aneurysm, endovascular stent-graft application has become an established method of treatment. To observe the outcomes of the procedure as the size change of aneurysm in relation with endoleak, a retrospective analysis was done for the consecutive cases who undertook the procedure. Materials & Method: Stent-graft was applied to the aortic aneurysm in 33 patients. The location of the aneurysm was thoracic in 11 patients and abdominal in 22 patients. CT angiographic was done for the follow-up evaluation to analyze the aneurysm size and the presence of endoleak. Results: Technical success rate was 97% (32/33). The primary success rate without endoleak was 84% (28/33). The secondary success was 90% (30/33). During the follow-up period of 3 months to 7years and 6months in 26 patients, a secondary endoleak developed in 5 cases. Post-implantation syndrome developed in 17 cases (51%). Among the 14 cases with follow-up imaging data for size, endoleak was negative in 10 cases. The aneurysm decreased in 5 cases, stable in size in 4 cases and enlarged in one case (10%).Among the 4 cases with endoleak positive, the aneurysm enlarged in two cases (50%). Conclusion: In the stent-graft application for aortic aneurysm, there is high chance of decrease of aneurysm size in those cases with endoleak negative. However, the aneurysm may increase and eventually rupture in the cases with en do leak positive. Close observation with CT angiography is necessary for the evaluation for the presence of endoleak and size change.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.685-692
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• 1991

Twelve patients underwent surgical interventions for aortic aneurysms consecutively from September 1986 to September 1990 in the Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. They were all men ranging in age from 25 to 68 years with the mean age of 48 years. Five patients of them had aneurysms involving ascending aorta, one aneurysm involving both ascending and descending aorta, four aneurysms involving descending thoracic aorta, and the others had aneurysms involving abdominal aorta. According to morphological classification, six cases of them were in dissection and the others in fusiform aneurysms. All the cases were pathologically true aneurysms and four of them were in acute status. According to causal classification, seven patients of them had atherosclerosis, three cystic medial necrosis, and the others had syphilis and trauma respectively. Six patients with ascending aortic aneurysm had annuloaortic ectasia with aortic regurgitation and underwent ascending aortic graft and aortic valve replacement[Bentall`s operation]. The others with descending thoracic and abdominal aortic aneurysms underwent Dacron graft replacement. Both hemorrhage necessitating reopening of the chest and wound dehiscence were observed in three patients and hoarseness in one patient. Cerebrovascular accident occurred three and a quarter years postoperatively in one patient and he died two days later. The others were followed up via OPD and have been doing well postoperatively.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.103-107
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• 1997

A very rare case of mycotic aneurysm in the descending thoracic aorta due to salmonellosis was treated in our hospital The patient was a 62 year-old male who 48 days before the operation was admitted to the depart,cent of internal medicine complaining of fever. nausla. vomiting, and loose stool. He was treated for 35 days and discharged. Three days after discharge, however, the patient was readmitted to the hospital comE긴ainin프 of $\ulcorner$i포ht uppe$\ulcorner$ 킥uadrant abdominal pain. Fever developed on the third hospiti린 day, and on the eighth hospital day, the patient complAined of back pain and epigastric pale. A simple chest x-ray showed evidence of hemothorax in the left plueral space, and therefore, computed tomography of the chest was done. The patient was diagnosed as a ruptured mycotic aneurysm of the descending thoracic aorta, and was transferred to our Department of Thoracic and CArdiovascular Surgery. The aneurysm and infected tissues was widely debrided, and the site was then patched with a Dacron graft. Salmonella choleraesuis was identified in the blood and aneurysm cultures, and antibiotics were administered for weeks according to the sensitivity of the organism. The patient experienced no complication thereafter and for the last three months since the operation, he has been leading a healthy and normal social life.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.365-368
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• 2013

We report a case of concurrent saccular aneurysms caused by a penetrating atherosclerotic ulcer of the thoracic and abdominal aorta that were successfully treated by staged endovascular repair. Even though surgical open repair or endovascular repair is the treatment option, use of endovascular repair is now accepted as an alternative treatment to surgery in selected patients. To prevent contrast medium-induced nephropathy and spinal cord ischemia caused by a simultaneous endovascular procedure, a saccular aneurysm of the descending thoracic aorta was excluded by stent graft, followed by the placement of a bifurcated stent graft in the infrarenal abdominal aorta one month later.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.599-604
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• 2002

Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.230-235
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• 2012

Background: Although patients with a ruptured abdominal aortic aneurysm (RAAA) often reach the hospital alive, the perioperative mortality is still very high. We retrospectively reviewed thirty patients who underwent repair of RAAA to identify the factors affecting postoperative mortality in a single hospital. Materials and Methods: Between September 2007 and May 2011, thirty patients with RAAA underwent emergent surgery (n=27) or endovascular aneurysm repair (n=3). Their medical records were retrospectively reviewed regarding three categories: 1) preoperative patient status: age, gender, vital signs, serum creatinine, blood urea nitrogen, hematocrit, and hemoglobin level: 2) aneurysmal status: size, type, and rupture status; and 3) operative factors: interval time to operating room, operative duration, and amount of perioperative transfusion. Results: The 30-day postoperative mortality rate was 13.3% (4/30); later mortality was 3.3% (1/30). On multivariate analysis, the initial diastolic blood pressure (BP), interval time to operating room and amount of preoperative packed cell transfusion were statistically significantly linked with postoperative mortality (p<0.05). Conclusion: In this study, preoperative diastolic BP, preoperative packed cell transfusion amount and interval time between arrival and entry to operating room were significantly associated with postoperative mortality. It is important to prevent hemorrhage as quickly as possible.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.34-40
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• 2009

Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.