• Title/Summary/Keyword: cardiac mass

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Postnatal left Ventricular Outflow Tract Obstruction Caused by Multiple Rhabdomyoma Tumors (다발성 횡문근육종으로 인해 출생직후 발생한 좌심실유출로 폐쇄)

  • Song, Seung-Hwan;Jun, Tae-Gook;Choi, Min-Suk;Yang, Ji-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.725-728
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    • 2010
  • Rhabdomyoma is the most common benign cardiac neoplasm in neonates. Most patients with rhabdomyoma experienced spontaneous regression. Yet some of them need surgical therapy because of hemodynamic problems of the heart such as arrhythmia, outflow tract obstruction and valvular dysfunction. We found multiple masses in both ventricles on the patient's fetal echocardiogram. Heart failure caused by severe left ventricular outflow tract obstruction quickly presented after birth. The mass interfering with the outflow tract was resected via the transaortic approach at the first day of birth. Postoperative echocardiography showed complete release of the outflow tract obstruction. He was discharged on the postoperative day 8. During the 3 years of follow up, we found that the sizes of the remnant masses had gradually decreased.

Surgical Treatment of Lung Cancer (폐암의 외과적 치료)

  • 신현종
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.473-482
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    • 1987
  • The records of 65 patients with a confirmed diagnosis of primary lung cancer who underwent surgical therapy at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Hospital were analyzed during the period of 8 years and 4 months, from August, 1978 to December, 1986. The peak incidence was observed in the 5th decade of life and the mean age was 52.9 years old. Male versus female ratio was 8.3:1 Cough was the most frequent presenting symptom, 76.9% then chest discomfort, hemoptysis and dyspnea followed in order. 44.6% of the patient had 2 months of prediagnostic symptomatic period, 72.3% had 5 months, and the mean was 5.7 months. As for preoperative diagnosis, 62 of total 65 patients revealed the mass lesion on simple chest x-ray, and 56 of 65 patients on bronchoscopic biopsy, 10 of 37 patients on sputum cytology and 15 of 15 patients on computerized tomography of the chest were positive. Of the 65 patients, 35 [53.9%] had squamous cell carcinoma, 18 [27.7%] adenocarcinoma, 3 [4.6%] large cell carcinoma, and 3 [4.6%] small cell carcinoma all which was oat cell carcinoma. 83.1% of the total patient was resectable, and 34 underwent pneumonectomy and 20 lobectomy. Of these 65 operations, 29 was radical resection, 25 palliative, and 11 exploratory thoracotomy. As for clinical stagings, 23 patients were in Stage, I, another 23 in Stage II and 19 in Stage III, while 16 was in stage, I, 14 in stage ll and 35 in stage III in postoperative staging evaluation. In correlation of postoperative TNM classification and radical resection, those patients who had lung cancer of stage I [14/16] and stage II [9/13] had more radical resection. As postoperative complications, one patient had massive bleeding, two empyema, one empyema with bronchopulmonary fistula, and one cardiac herniation. Operative mortality rate was 1.5% [1 patient]. Mean duration between 1st operation and discovering recurrence in 18 patients was 12.7 months.

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Acute Suppurative Pericarditis Caused by Liver Abscess -1 case report- (간농양에 속발한 급성화농성 심 낭염 -1례 보고-)

  • 홍장수;노윤우
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.785-788
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    • 1996
  • Pericardial abscess due to liver abscess is a very rare disease, the result of which is usually fatal when untreated. But a combination of antibiotics therapy and pericardial drainage has broug t good result. A 32-year-old man was admitted to the emergency room because of fever and chilling sensation. Chest X-ray showed cardiomegaly and a mass lesion In the left lobe of liver on ultrasonography. The echocardiography revealed impending cardiac tamponade. Pus drainage of the liver abscess through per- foration of right diaphram and pericardiotomy were performed. The pericardium was thickened and 600 ml of purulent fluid and necrotic debris were drained. Fibrin clots were firmly attached to the undelying myocradium. Histological examination of the pericardium showed acute inflammation with microabsscess and Escherichia soli was cultured from pericardial pus. He was discharged after 4 weeks on antibiotics, but Doppler echocardiograpy revealed a slightly thickened pericardium with a mild constrictive physiology.

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Tricuspid Papillary Fibroelastoma Mimicking Tricuspid Vegetation in a Patient with Severe Neutropenia

  • Choi, Kuk Bin;Kim, Hwan Wook;Kim, Do Yeon;Jo, Keon Hyon;Choi, Hang Jun;Hong, Seok Beom
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.195-198
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    • 2016
  • We report a 72-year-old male with known myelodysplastic syndrome who presented to the emergency department with a 7-day history of fever and dyspnea. Echocardiography revealed a round echogenic mass $13{\times}16mm$ in size attached to the atrial side of the tricuspid valve. Considering the high risk of infective endocarditis in the patient with a low absolute neutrophil count ($130/mm^3$), emergency surgery was performed. Intraoperatively, a single gelatinous neoplasm was resected, and subsequent reconstruction of the involved leaflet was accomplished using autologous pericardium. The tumor was pathologically confirmed as papillary fibroelastoma with no evidence of infective endocarditis. Papillary fibroelastoma is a rare cardiac neoplasm that occurs in either the mitral or aortic valves. Interestingly, a few cases of tricuspid valve papillary fibroelastoma have been reported so far. Similar echocardiographic findings between vegetation and tricuspid valve neoplasm make it difficult to distinguish these two disease entities.

Applicability and Program Effects of Tai Chi Exercise in Outpatients with Coronary Artery Disease (관상동맥질환자를 위한 건강타이치 운동중재의 적용 및 효과분석)

  • Song, Rha-Yun;Park, In-Sook;So, Hee-Young;Kim, Hyun-Lee;Ahn, Suk-Hee
    • Korean Journal of Adult Nursing
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    • v.20 no.4
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    • pp.537-547
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    • 2008
  • Purpose: The study aimed to apply Tai Chi exercise to patients with coronary artery disease for 6 months, and to examine changes on body composition, physical strength, and cardiovascular risks. Methods: Applying a quasi experimental design with a nonequivalent control group, 90 subjects with cardiovascular disease were recruited at C university hospital. For 6 months, 44 subjects performed Tai Chi exercise once a week and daily home exercise, while 46 subjects did not. Body composition was assessed by body mass index, % body fat, and waist-hip ratio; physical strength by balance, mobility, flexibility, grip strength, and back muscle strength; and cardiovascular risk checklist for fixed and modifiable risk factors. Data were analyzed by SPSS/WIN program with ANCOVA to consider group differences at the pretest. Results: The subjects were 66 years old in average. In 6 months, Tai Chi group improved significantly in balance, mobility, and flexibility with decreased modifiable cardiovascular risks after adjusting for the pretest scores. Conclusion: Tai Chi exercise was safely applicable to individuals with coronary artery disease, and effective in some measures of physical strength and modifiable cardiovascular risks. It could be an alternative exercise for outpatient cardiac rehabilitation program in this population.

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Heart Diseases Prevalence of Elementary School Children in Kyonggi Province (경기도 초등학교 아동의 심장질환 유병률)

  • Chun, Byung-Chul;Yum, Yong-Tae;Kim, Soon-Duck
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.36-44
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    • 2000
  • Objective : The heart diseases are known as a major cause of sudden death, as well as a cause of poor life-quality of school-age children. But there have been few mass screening of heart diseases in these children in Korea. This study was done to estimate the prevalence of heart diseases of these population. Methods : We screened all elementary students(grade 1) in 12 cities and 16 counties(Gun) in Kyonggi province from 1992 to 1955. The first screening was done by auscultation of doctors and simultaneously by checking using 'auto-interpreter of EKG-cardiac sound' (Fukuda Densi ECP 50A). We conducted luther examinations to whom classified as being abnormal condition in first screening, by using EKG, chest x-ray, doppler echocardiograpy(if needed). Results : The total number of examined students was 161,308(92% of the population), the male were 83,238 and female were 78,070. The congenital heart diseases(CHD) patients were 290(18 per 10,000) - male 155(18.6 per 10,000) and female 135(17.3 per 10,000). The most frequent disease was ventricula septal defect(VSD, 45.5%), Atrial septal defect(ASD, 14.8%), Tetralogy of Follot(TOF, 11.7%), and Patent Dutus Arteriosis(PDA, 7.6%) in order. In female, the order was VSD(48.1%), ASD(13.3%), TOF(11.1%), and PDA(10.4%). The total number of EKG abnormality were 433(62.7 per 10,000) among 69,056 screened children in 1995. The complete right bundle branch block(CRBBB) and paroxymal ventricular contraction(PVC) were frequent(26.6%, 26.3% in each), and incomplete right bunddle branch block(IRBBB, 14.6%), paroxymal atrial contraction(PAC, 6.7%), abnormal Q(5.8%), Wolf-Pakinson-White syndrom (5.5%) in order. In female, the most frequent abnormality was PVC(29.8%), and CRBBB(19.9%) in order. Conclusion : We could present the stable prevalence of the rare heart disease. The prevalence of congenital heart diseases was 18.0 per 10,000 and of EKG abnormality was 62.7 per 10,000 among school children.

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Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass (정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예)

  • Park Han Gyu;Choi Chang Woo;Lee Jae Wook;Her Keun;Shin Hwa Kyun;Won Yong Soon
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.72-75
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    • 2006
  • In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).

Long-term Effectiveness of Enzyme Replacement Therapy in Fabry Disease (파브리병에서 효소대치요법의 장기적 효과)

  • Kim, Ja Hye;Cho, Ja Hyang;Choi, Jin-Ho;Lee, Beom Hee;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.37-41
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    • 2014
  • Fabry disease is an X-linked disease caused by deficiency of the lysosomal enzyme alpha-galactosidase A. Affected males present anhydrosis, acroparesthesia and angiokeratoma, and subsequently cardiac, cerebral and renal complications are followed. Females and atypical variants show heterogeneous clinical symptoms. In 2001, two recombinant enzymes were approved for Fabry disease: agalsidase alpha and agalsidase beta. Since the introduction of enzyme replacement therapy (ERT), the number of long-term follow-up studies has been reported. Long-term ERT showed effectiveness on renal function in patients with chronic kidney disease, decrease or stabilization of left ventricular mass, and improvement of pain and quality of life. However, there were limited effects on cerebrovascular events and their mortality. Current literatures on the clinical effect of ERT have reported limited datain adult patients who have already advanced disease. Therefore, further study for pre-symptomatic patients and atypical variants is needed to verify the impact of ERT. This review summarized recent progresses in ERT and limitations of long-term effect of ERT in patients with Fabry disease.

A Case Report of Mediastinal Leiomyosarcoma (종격동내 평활근육종 1예)

  • Lee, Won-Yeon;Ahn, Kang-Hyun;Jung, Soon-Hee;Koh, Jae-Hyang;Yoo, Byung-Soo;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.658-662
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    • 1994
  • The leiomyosarcoma is uncommon tumor that consists of 10% of all sarcoma incidence and commonly arise from retroperitoneum or mesentery. But leiomyosarcoma arose from mediastinum is very rare and only incidental case report is present. Mediastinal leiomyosarcoma may originate from superior vena cava, pulmonary artery, small vessels of alveoli, esophagus and cardiac muscle. Common symptoms that are related with leiomyosarcoma of mediastinum are cough and dyspnea but dysphagia, chest pain and hemoptysis can be produced. Although long term survival after complete resection of tumor was reported in localized disease, there was no effective therapy that prolong the survival in patients who had disseminated disease or huge tumor mass. We report the case of posterior mediastinal leiomyosarcoma confirmed by aspiration cytology and immunohistochemical staining, along with a review of literature.

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Isolation and Characterization of Trophoblast Stem Cells-like Cells Derived from Human Term Placenta

  • Na, Kyu-Hwan;Shin, Kyung-Seon;Choi, Jong-Ho;Cha, Dong-Hyun;Kim, Gi-Jin
    • Development and Reproduction
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    • v.14 no.3
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    • pp.155-162
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    • 2010
  • The trophectoderm is one of the earliest cell types to differentiate in the forming placenta. It is an important for the initial implantation and placentation during pregnancy. Trophoblast stem cells (TBSCs) develop from the blastocyst and are maintained by signals emanating from the inner cell mass. However, several limitations including rarity and difficulty in isolation of trophoblast stem cells derived from blastocyst still exist. To establish a model for trophoblast differentiation, we isolated TBSCs from human term placenta ($\geq$38 weeks) and characterized. Cell cycle was analyzed by measuring DNA content by FACS analysis and phenotype of TBSCs was characterized by RT-PCR and FACS analysis. TBSCs have expressed various markers such as self-renewal markers (Nanog, Sox2), three germ layer markers (hNF68, alpha-cardiac actin, hAFP), trophoblast specific markers (CDX-2, CK7, HLA-G), and TERT gene. In FACS analysis, TBSCs isolated from term placenta showed that the majority of cells expressed CD13, CD44, CD90, CD95, CD105, HLA-ABC, cytokeratin 7, and HLA-G. Testing for CD31, CD34, CD45, CD71, vimentin and HLA-DR were negative. TBSCs were shown to decrease the growth rate when cultured in conditioned medium without FGF4/heparin as well as the morphology was changed to a characteristic giant cell with a large cytoplasm and nucleus. In invasion assay, TBSCs isolated from term placenta showed invasion activities in in vivo using nude mice and in vitro Matrigel system. Taken together, these results support that an isolation potential of TBSCs from term placenta as well as a good source for understanding of the infertility mechanism.