• Title/Summary/Keyword: pericardium

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Pulmonary Artery Intimal Sarcoma with Lung Metastasis (폐 전이를 동반한 주폐동맥의 혈관 내막 육종)

  • 김인섭;정성철;김우식;배윤숙;신용철;정승혁;유환국;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.979-984
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    • 2003
  • Primary pulmonary artery sarcoma is very rare disease. The diagnosis of pulmonary artery sarcoma is frequently confused with pulmonary embolism because its clinical symptom and radiologic findings are similar with pulmonary embolism. It was often diagnosed at autopsy as it progresses rapidly. So Pulmonary artery sarcoma must be suspected if the origin of thrombus is not known and anticoagulation therapy is not effective. In this case, a 57 years old man who has been diagnosed pulmonary embolism was transferred to our department because of ineffective anticoagulant therapy and its worsening lesion despite of 5 month-therapy. In operative findings, it was pulmonary artery sarcoma that invaded to pericardium. There was angiosarcoma in right pulmonary artery, which metastasized to lung parenchyme. Under cardiopulmonary bypass, we resected main pulmonary artery and right lung. The Gore-tex graft was interposed between main pulmonary artery and left pulmonary artery. He was discharged after chemotherapy.

Infective Endocarditis Involving Aortic Valve, Mitral Valve, Tricuspid Valve, and luterventricular Septum -A Case Report (대동맥판막, 승모판막, 삼첨판막과 심실중격을 침범한 심내막염 -1예 보고-)

  • 박종빈;서동만
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.200-204
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    • 1997
  • This is a report of a successful management of a patient with infective endocarditis involving native aortic valve, mitral valve, tricuspid valve, and Interventric lar septum. A 16 year-old patient who underwent VSD patch closure, and aortic valvuloplasty at the age of 1 1 years showed Intractable congestive heart failure during antibiotics treatment for infective endocarditis. Operative findings revealed that there were large defect along the previous patch, aortic regurgitation with multiple perforations and vegetations, mitral regurgitation with vegetation, aortic paraannular abscess, interventricular myocardial abscess, and tricuspid regurgitation with perforations and vegetations. We reconstructed the interventricular defect with Dacron patch extending to the aortic valve annulus after radical debridement of all infected or devitalized tissues, and could implant aortic valve by anchoring to the reconstructed Dacron patch. Mitral valve was replaced and tricuspid valve was repaired with patient's own pericardium. The patient was discharged after antibiotics treatment for 6 weeks and in good condition without any sequelae for 12 months.

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BIOCOMPATIBILITY OF ABSORBABLE COLLAGEN MEMBRANES IN HUMAN PDL-DERIVED FIBROBLASTS IN VITRO (인간 치주인대 유래 섬유모세포에 대한 흡수성 교원질 차폐막의 생체적합성)

  • Kwon, Yong-Dae;Lee, Baek-Soo;Jue, Sung-Sook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.3
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    • pp.272-278
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    • 2006
  • Purpose: This study is designed to evaluate biocompatibility of three types of absorbable collagen GBR membrane in vitro. Material and Method: The human PDL fibroblasts culture was obtained through typical way and the cells used in the experiment was forth passage. The membranes examined were Experimental group A, B, C. All the 3-experimental groups were made of bovine pericardium and the membranes were excised into 5$\times$5mm respectively. The samples of the membranes were fixed on the 24-well plate with the double-sided adhesive tape. Then, 2ml of cell suspension which included $2{\times}10^4$cells was inoculated into the 24-well plate, and the cells were cultured for 1 week. Cellular viability and the alkaline phosphatase activity were measured with ELISA. The membranes in the culture were processed to examine with SEM. Results: The survival rate was highest in control and Experimental group A is the next, group B and group C in order of the value. The values are analyzed for statistical difference using Wilcoxon test. All the values of experimental groups are significantly lower than those of control, and the vaules among the experimental groups significantly differ from each other. Alkaline phosphatase level was identical order with the viable cell rate. SEM examination revealed that the PDL fibroblasts adherent on culture dish (control) and group A were spindle-shaped, but on group B and C, the cells were round-shaped without processes.

Survival Analysis of Hospitalized Mesothelioma Patients (중피종 환자에 대한 생존분석 - 한 종합병원의 입원환자를 중심으로 -)

  • Kim, Chun-Bae;Jung, Sang-Hyuk;Lee, Kyung-Jong;Kang, Jong-Doo
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.1 s.29
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    • pp.77-86
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    • 1990
  • Between 1977 and 1987, 20 patients with mesothelioma were treated at Severance Hospital. Data was gathered from medical charts at the time of hospitalization of mesothelioma patients and from a follow-up questionnaire by mail or telephone. The results acquired were as follows : 1. Among the 20 patients, 11 men and 9 women with mesothelioma were identified. The mean age at hospitalization was 47 years and 11 mesothelioma patients were known or presumed to be dead during the different observation periods. 2. Only one mesothelioma patient had a definite history of occupational asbestos exposure. 3. The sites of origin of mesothelioma were the pleura(13), peritoneum(2), pericardium(2), mediastinum (2), and pelvis(1). Common symptoms included dyspnea, chest pain, abdominal distension, etc. 4. Pathologically, mesotheliomas were divided into 14 malignant types and 6 benign types ; and histologically, 8 fibrous mesotheliomas and 3 epithelial mesotheliomas were shown. 5. There was a statistically significant difference in survival rate according to pathologic type and smoking status. In the groups with malignant mesothelioma, 50% survival time from first symptoms was 18 months and that from diagnosis was 11 months. Also, 75% survival time from diagnosis was 6 months in the smoking groups and 19 months in the non-smoking groups.

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Mesothelial Cyst of the Posterior Mediastinum - A case report - (후 종격동에 발생한 중피낭종 - 1예 보고 -)

  • Lee Jang-Hoon;Kwon Jin-Tae;Jung Tae-Eun;Kim Mi-Jin;Lee Jung-Cheul
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.655-658
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    • 2006
  • Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it’s locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 em at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.

Traumatic Diaphragmatic Hernia: A Report of 5 Cases (외상성 횡경막 탈장: 5례 수술 보고)

  • 장순명
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.163-168
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    • 1974
  • Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

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Surgical Treatment of Pulmonary Blastoma -A Case Report- (폐 모세포종의 외과적 치료 -1례 보고-)

  • 양수호;김병일
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1044-1047
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    • 1997
  • Pulmonary blastoma are a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or emb yonal in appearance. We report a pulmonary blastoma occurring in a 31 years old man. An abnormal shadow was detected in the right lower lung field in a routine chest X-ray film. The preoperative imaging films showed about a 5cm sized well circumscribed solid tumor of the right lung. A preoperative clinical diagnosis of primary lung cancer was considerd. The operative field showed that the hard, round mass, 6$\times$5$\times$4cm in diameter was localized in middle lobe of the right lung, and partially adhered to the upper lobe, pericardium and diaphragm. Right middle lobe lobectomy, right upper lobe wedge resection, partial pericardiectomy and diaphragm resection with plication was performed with radical Iymph node dissection. Histopathologic diagnosis was pulmonary blastoma (Biphasic blastoma). It is considered that the prognosis of biphasic blastoma is worse than WDFA(well differentiated fetal adenocarcinoma). There are no other available treatments except for surgical resection. It is suggeste that it is necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.

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Different Pathology between General and palms-and-soles hyperhidrosis in Korean Medicine and Medicine (자한(自汗)과 수족한(手足汗)에 대한 한의학 및 의학적 고찰)

  • Lee, Wook Jin;Kim, Byoung Soo
    • The Journal of Korean Medicine
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    • v.41 no.1
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    • pp.11-20
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    • 2020
  • Objectives: We noticed that hyperhidrosis can be differentiated by whether it is topical or systemic in both Korean medicine(KM) and Modern medicine(MM). Comparing between topical and systemic sweating, we will figure out similarity between KM and MM about stimuli on sweat. Methods: All research is done by finding information on text-book, article, books. Results: Hyperhidrosis is differentiated by whether it is topical or systemic in both Korean medicine(KM) and Modern medicine(MM). First, systemic sweating(SS) is affected by body temperature. In KM, Heat and Cold(plus yang deficiency) can make human sweat systemically. In MM, heat is also mentioned as stimulus. Second, topical sweating(TS) can occur on emotionally-stressed situation especially on palms-and-soles. In KM, this phenomenon is explained by heart spirit(心神) and disease transmitted by pericardium meridian(手厥陰心包經 是動病). In MM, anatomically hyperhidrosis on palms-and-soles is generated by adrenergic sympathetic nerve which is involved with stress. Third, sweating on palms-and-soles also can be generated by internal organ. In KM, hyperhidrosis on palms-and-soles is explained as illness on stomach meridian(足陽明胃經). The 70% of parasympathetic nerve is vagus nerve which is located at internal organs-usually gastrointestinal tract. In that point, stomach and parasympathetic nerve seem to be involved in hyperhidrosis on palms-and-soles. Conclusion: Hyperhidrosis is differentiated similarly by whether it is topical or systemic in both Korean medicine and Modern medicine. Conserving each perspective of KM and MM, one perspective can be useful to other by supplementing other's weak point.

Study on the 'poems of prograde' of twelve meridians and 'poems of acupoints' (십이경맥(十二經脈)의 순행가(循行歌)와 경혈가(經穴歌)에 대(對)한 연구(硏究);십이경맥(十二經脈)의 순행(循行) 부위(部位) 및 방향(方向)과 경혈가(經穴歌)의 분류(分類)를 위주로)

  • Kang, Dong-Yun;Jo, Hak-Jun;Kim, Ho-Hyun
    • Journal of Korean Medical classics
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    • v.20 no.2
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    • pp.61-123
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    • 2007
  • We translated 'poems of prograde' and 'poems of acupoints' which in the poems of acupoints and based on that, We considered the circulating direction and region of twelve meridian comparing the notion in common today with that in the 'poems of acupoints'. Finally, we got the conclusion like below 1. About circulating line of lung meridian, it'll be proper to correct that lung meridian passes through inner edge of biceps brachii muscle like heart and pericardium meridian. 2. On the part of kidney meridian in 'poems of prograde', it's right to be corrected as the circulating line that thru the inner line of vertebrae, enters heart and lung, and scattered tho breast. 3. 'Poems of prograde' can be separated two kinds go by starting-acupoints, ending- acupoints. First is 'poems of prograde' is begun from the end of members and ended in the body. Second is from Jungbu(中府) to Kimun(期門), circulating the members and the body with no ending. 4. On the above, we can find first 'poems of prograde' in "Chimkudaejeon(鍼灸大全)", "YangKyungjechimkujeonso(楊敬齋鍼灸全書)", "Chimkudaeseong(鍼灸大成)", also second can be found in "Neungmunjeonsudonginjihyul(凌門傳授銅人指穴)", "Chimkushinso(鍼灸神書)", "Kumchimbijeon(金針秘傳)", "Kyungrakhoepyun(經絡匯編), "Kyungrakko(經絡考)", "Jungsohoechamdongindosol(重西匯參銅人圖說)", "Kyungrakdoko(經脈圖考)", "ChimkuChuiyoung(針灸聚英)", "Shipsakyoungbalhwee(十四經發揮)", "Jakushimbopyokyul(刺灸心法要訣)", "Yukyoungdoik(類經圖翼)", "Yihakimmun(醫學入門)", etc. 5. Drawing an inference from above, the forms of "Jokbishibilmaek(足臂十一脈)" and "YumYangshibilmaek(陰陽十一脈)" are in "Mawangtoebaekso(馬王堆帛書)", are rather foreforms of circulation line that from the end of members and ended in the body than meridian prograde.

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Comparison of 29 Diagrams of Heart originated from MingTangZangFuTu(明堂臟腑圖) (명당장부도(明堂臟腑圖)에서 기원한 심장도(心臟圖) 29종의 비교)

  • Jo, Hak-jun
    • Journal of Korean Medical classics
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    • v.30 no.3
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    • pp.55-76
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    • 2017
  • Objectives : The transition of the 29 diagrams of Heart originated from MingTangZangFuTu will be used to understand the shape of heart and the changes of people's understanding of heart. Methods : The 29 diagrams of Heart originated from MingTangZangFuTu are divided according to their shape elements (Heart itself, internal curvatures, structures above heart, wuzangxi, and excursus). Then its transitions are analyzed, and each shape element is compared to modern anatomy and its textual basis is searched. Results : The lengthy cylinderical organ situated above the heart is composed of upper part consisting with joints and the lower part void of joints. The upper part is Pyewan (such as the lungs) and fall into trachea. The lower part is Xinxi or Feixi which are either relative vein (or aorta) or left bronchus that passes behind the heart. This depiction of the structures around the heart can be considered to have composed by actual observance of a physical heart, a method that is similar to anatomy. However, the shape of the heart itself is described as a lotus flower that has not been bloomed, a depiction which finds its origin from Zhongguangbuzhu huangdineijing suwen (762). The three short curvatures inside the heart is described as Pericardium, influenced by Shisijingfahui (1341) in its depiction, or as sammo, influenced by Nanjing. Structures that are connected directly from the heart to spleen, kidney, and uterus are not found in modern anatomy. The saying in Excursus "All cords of five internal organs belong to heart" is based on Huatuoxuanmenneizhaotu, and this is changed to the saying cords of four internal organs belong to heart in Leijingtuyi for the first time. Conclusions : The authors of medical scriptures at the time did not have a method of direct observance when they were copying heart diagrams. Therefore, they made changes to the source material's diagram and excursus while being influenced by Nanjing, Huatuoxuanmenneizhaotu, and Shisijingfahui. Then the doctors' understandings with regards to the shape and function of heart were reflected during that process.