• 제목/요약/키워드: cardiac mass

검색결과 187건 처리시간 0.024초

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

  • 송승환;전태국;최민석;양지혁
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.725-728
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    • 2010
  • 횡문근육종은 영아에서 발생하는 가장 흔한 심장 내 양성종양으로 많은 수에서 그 크기가 감소하여 자연 소멸되는 것으로 알려져 있다. 하지만 일부 환자에서는 성장의 기능적 문제를 야기하여 수술적 치료를 필요로 하기도 한다. 환아는 산전 초음파에서 심실 내 다발성 종양이 발견되었으며 출생 직후부터 심한 좌심실 유출로 폐쇄로 인한 심장기능부전이 발생하였다. 생후 1일째 응급으로 수술을 시행하였으며 대동맥 절개를 통한 경판막 접근법으로 유출로를 막고 있는 종양의 일부분만을 절제하였다. 수술 후 시행한 초음파에서 유출로 폐쇄가 완전히 없어진 것을 확인할 수 있었으며, 3년간 정기적으로 경과 관찰한 결과 남아있는 종양은 그 크기가 점차 줄어드는 것을 확인할 수 있었다.

폐암의 외과적 치료 (Surgical Treatment of Lung Cancer)

  • 신현종
    • Journal of Chest Surgery
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    • 제20권3호
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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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간농양에 속발한 급성화농성 심 낭염 -1례 보고- (Acute Suppurative Pericarditis Caused by Liver Abscess -1 case report-)

  • 홍장수;노윤우
    • Journal of Chest Surgery
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    • 제29권7호
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    • pp.785-788
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    • 1996
  • 간농양에 이은 급성 화농성 심낭염은 드문 질환이다. 급성화농성 심낭염은 적절한 치료가 이루어지지 않을 경우 사망율이 매우 높은 위 험한 질환이다. 환자는 32세 남자 환자로 발열, 오한, 상복부동통 및 호흡곤란을 주소로 응급실로 내원 하였다. 단순 흉부사진상 심비대의 소견을 보이고 있었으며, 복부초음파상 간좌엽에 종괴가 있었다. 심초음파상 임박 심장압진의 소견을 보이고 있었다. 응급으로 횡격막천공을 통해 간농양을 배농시켰고 심낭절개술을 시 행하였다. 심낭은 비후되어 두꺼워져 있었고 600m1의 악취가 나는 농액과 괴사조직들이 배액되었다. 섬유소응괴(abrinclot)가심근과유착이 있었다 조직학적 검사상심낭은급성 염증소견과 미세한 괴사 소견을 보이고 있었고, 균배양검사상 혈액과 배농액 에서 모두 Escherichia coli가 나왔다. 환자는 항생제 치료 받고 4주만에 퇴원 했고 심초음파상 약간의 교착성 심낭염의 소견을 보였다.

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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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    • 제49권3호
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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.

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

  • 송라윤;박인숙;소희영;김현리;안숙희
    • 성인간호학회지
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    • 제20권4호
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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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경기도 초등학교 아동의 심장질환 유병률 (Heart Diseases Prevalence of Elementary School Children in Kyonggi Province)

  • 천병철;염용태;김순덕
    • Journal of Preventive Medicine and Public Health
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    • 제33권1호
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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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정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예 (Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass)

  • 박한규;최창우;이재욱;허균;신화균;원용순
    • Journal of Chest Surgery
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    • 제39권1호
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    • pp.72-75
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    • 2006
  • 46세 남자가 특별한 문제없이 지내오던 중 내원 한달 전부터 발생된 흑색변과 10일 전부터 시작된 상복부 통증 및 호흡곤란을 주소로 내원하였다. 복부 초음파와 복부 전산화 단층촬영상 우측 콩팥세포암종과 하대정맥 폐색이 발견되어 우측 콩팥절제술과 정맥-정맥간 우회를 이용한 하대정맥 혈전색전 제거술을 시행받았다. 콩팥세포암종에 기인한 하대정맥 폐색시 심정지와 심페우회술을 사용하지않고 정맥관류의 차단 없이 비교적 간단하게 수술할 수 있는 방법으로 정맥-정맥간 우회술을 이용하여 수술 성공한 사례가 있어 보고하는 바이다.

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

  • 김자혜;조자향;최진호;이범희;유한욱
    • 대한유전성대사질환학회지
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    • 제14권1호
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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.

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

  • 이원연;안강현;정순희;고재향;유병수;용석중;신계철
    • Tuberculosis and Respiratory Diseases
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    • 제41권6호
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    • pp.658-662
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    • 1994
  • 저자등은 종격동에서 늑막삼출액과 함께 종물이 있는 소견을 보였던 환자에서 세포진검사 및 면역화학적 검사를 통하여 평활근육종으로 진단된 1예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.

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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
    • 한국발생생물학회지:발생과생식
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    • 제14권3호
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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.