1.Familial Atrial Myxoma with Carney's Complex: 1 Case.
Myung Chun KIM ; Jae Young LEE ; Choo Chul PARK ; Seh Young YOU ; Kyu Seok CHO
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(8):816-819
Myxomas are the most common form of intracardiac tumors and are found primarily in the left atrium. In rare cases, Carney and associates have described a syndrome called "the complex of myxoma" consisting of cardiac myxoma, which characteristically is familial, in assocation with two or more of the follow conditions: myxomatous masses (cardiac myxoma, cutaneous myxosma, and mammary myxoid fibroademoma), spotty pigmented lesions of the skin, and endocrine disorders. We report a case of familial atrial myxoma with Carney's complex in a 19-year old woman who has spotty pigmentations on her face, and left atrial myxomas, and myxoma on the right nipple. Her mother and sister share the left atrial myxoma. The myxomas originated in the septum of the left atrium and the anterior leaflet of the mitral valve were successfully excised. In conclusion, family members of affected patients should be screened periodically with echocardiography in an attempt to identify asymptomatic cardiac myxomas. Complete excision and postoperative follow up are necessary to rule out the muticentricity and high rate of recurrent lesions.
Echocardiography
;
Female
;
Follow-Up Studies
;
Heart Atria
;
Heart Neoplasms
;
Humans
;
Mitral Valve
;
Mothers
;
Myxoma*
;
Nipples
;
Pigmentation
;
Siblings
;
Skin
;
Young Adult
2.Primary Undifferentiated Sarcoma of Left Atrium.
Myung Chun KIM ; Jae Young LEE ; Choo Chul PARK ; You Seh YOUNG ; Kyu Seok CHO
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(8):811-815
Primar99y cardiac tumors are rare and about 25% of primary cardiac tumors are malignant. A primary undifferentiated cardiac sarcoma, which very rare, is presented as follows: A 28-year old woman at the 32th week of pregnancy was admitted to the hospital because of dyspnea. A large intracardiac (left atrium) tumor was found with cardiac echocardiography and MRI. Emergency operation was performed under the diagnosis of left atrial myxoma. After Cesarean section, LA-tomy was done under the cardiopulmonary bypass. Tumor removal including endocardium of left atrium was done and final pathologic diagnosis was primary undifferentiated laft atrial sarcoma. After adjuvant radiotherapy, she has been followed up in out patient bases without problems up to now.
Adult
;
Cardiopulmonary Bypass
;
Cesarean Section
;
Diagnosis
;
Dyspnea
;
Echocardiography
;
Emergencies
;
Endocardium
;
Female
;
Heart Atria*
;
Heart Neoplasms
;
Humans
;
Magnetic Resonance Imaging
;
Myxoma
;
Pregnancy
;
Radiotherapy, Adjuvant
;
Sarcoma*
3.Delayed Bronchoplasty in Complete Transection of Left Main Bronchus after Blunt Trauma.
Myung Chun KIM ; Jae Young LEE ; Kyu Seok CHO ; Choo Chul PARK ; Seh Young YOU
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(2):182-185
Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography (CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.
Accidents, Traffic
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Bronchi*
;
Delayed Diagnosis
;
Early Diagnosis
;
Lung
;
Suction
;
Thorax
4.Thymic Carcinoid Tumor: 1 Case report.
Jae Young LEE ; Myung Chun KIM ; Seh Young YOU ; Hwang Rae JO ; Hong Mo KANG ; Moon Ho YANG
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(3):319-323
Thymic carcinoid tumor is a rare mediastinal tumor, which was firstly described by Rosai and Higa in 1972. A carcinoid tumor of the thymus has recently been regarded as a distinct tumor from thymoma, and is probably Kultschizky cell origin. The pathologic diagnosis of thymic carcinoid is made from findings from light microscopy, immunohistochemical studies and electron microscopy. About 50% of thymic carcinoids were seen with endocrinopathies. Recurrences and extrathoracic metastasis are characteristics of thymic carcinoids. Surgical removal of the intial and tumor recurred are considered to be the most effective treatment today. However, the role of the adjuvant radiotherapy and the chemotherapy is still uncertain. Herein we report a case of thymic carcinoid tumor, which was confirmed by operation and pathologic study.
Carcinoid Tumor*
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Diagnosis
;
Drug Therapy
;
Mediastinal Neoplasms
;
Microscopy
;
Microscopy, Electron
;
Neoplasm Metastasis
;
Radiotherapy, Adjuvant
;
Recurrence
;
Thymoma
;
Thymus Gland
;
Thymus Neoplasms
5.Protective Effect on the Rat's Myocardium with Changes in Magnesium Concentrations.
Chi Wook HONG ; Kyu Seok CHO ; Seh Young YOU
The Korean Journal of Thoracic and Cardiovascular Surgery 1997;30(1):11-16
The increasing use of coronary perfusates for the protection of the human heart during ischemic cardiac arrest has placed great emphasis on the need for a rational and safe formulation. For the purpose of this study isolated rat hearts were connected to retrograde nonworking perfusion system proposed by Langendorff, and then perfused for 20 minutes by coronary infusates of magnesium concentration of 1.66 m Mol per liter (groupA, n=10) or 15 mMol per liter (groupB, n=10). After 20 minutes perfusion, cold cardioplegic solution (modified St. Thomas' Hospital solution) was infused for 2 minutes, and prepared within 4degrees C Krebs-Henseleit solution. Finally, 20 minutes of cononay reprsfusion was reestablished after l hour of cold ischemic cardiac arrest. Hemodynamic parameters (heart rate, left ventricular pressure, +/-dp/dt max. and coronany flow) and enzymes assay (creatine phosphokinase, lactic dehydrogenase and glutamic oxaloacetic transaminase) were performed each other at which rat heart was perfused for 20 minutes and reperfused for 20 minutes thereafter. There were significant differences in the recovery rate of heart rate, systolic left ventricular pressure, +dp/dt max, and coronary flow and reperfusion-perfusion ratio of creatine phosphokinase(P<0.05). But, there were no significant differences in the recovery rate of -dp/dt max, and reperfusion-perfusion ratio of lactic dehydrogenase and glutamic oxaloacetic acid(P>0.05).
Animals
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Cardioplegic Solutions
;
Creatine
;
Heart
;
Heart Arrest
;
Heart Rate
;
Hemodynamics
;
Humans
;
Magnesium*
;
Myocardium*
;
Oxidoreductases
;
Perfusion
;
Rats
;
Ventricular Pressure
6.Results of Segmental Resection and Reconstruction of the Trachea for Obstructive Tracheal Lesions.
Myung Chun KIM ; Choo Chul PARK ; Kyu Seok CHO ; You Seh YOUNG ; Bum Shik KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(8):792-798
BACKGROUND: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. MATERIALS AND METHODS: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. RESULTS: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. CONCLUSION: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.
Candidiasis
;
Consciousness
;
Granuloma
;
Humans
;
Mortality
;
Pneumonia
;
Sutures
;
Thyroid Neoplasms
;
Trachea*
;
Tracheal Stenosis
;
Tuberculosis
;
Vocal Cord Paralysis
;
Wound Infection
7.Experimental Studies on the Effect of Ginsenoside Rg1 Mixtures in an Isolated Rat Heart after Ischemic Arrest and Reperfusion.
Dong Won KIM ; Won Sun SHIN ; Jae Young LEE ; Bum Shik KIM ; Kyu Seok CHO ; Seh Young YOU
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(6):567-575
Panax Ginseng C.A. Meyer has been known for hundreds of years as the most valuable drug having mysterious effects among all the herbal medicines and plants in Korea. Also, many experimental studies have been performed recently that the various effects were identified and applied clinically. So we attempted an experimental study on the effect of ginsenoside Rg1 mixtures in an isolated rat heart with the use of the Langendorff model. The objective of this study was to determine whether this ginsenoside Rg1 mixtures would protect the myocardial injury after ischemic arrest and reperfusion. Isolated rat hearts were allowed to equilibrate for 20 minutes and were then subjected to 15 minutes of normothermic ischemia. After this ischemic period, isolated rat hearts were allowed to reperfusion for 10 minutes (Ischemic Group). In other group , isolated rat hearts were perfused for 60 minutes continuously with normothermia (Normothermic Group). Hemodynamic and biochemical parameters such as heart rate, left ventricular pressure, +dp/dt max, coronary blood flow and cardiac enzymes were measured during initial perfusion, ischemia, reperfusion period (Ischemic group) and 20, 40 and 60 minutes after continuous perfusion (Normothermic group). After completion of the experiment, this data was evaluated and the following results were obtained. 1. Heart rates showed an increase in both ischemic and normothermic experimental groups, but statistically significant differences were not identified. 2. LVP (Left Ventricular Pressure) showed statistically significant differences in both ischemic and normothermic experimental groups (p<0.005, p<0.01). 3. +dp/dt max showed statistically significant differences in both ischemic and normothermic experimental groups (p<0.01, p<0.01). 4. There were no statistically significant differences in coronary blood flow and cardiac cenzymes in all groups, but experimental groups seemed to have better protection and recovery. These results suggest that ginsenoside Rg1 mixtures has a protective effect on the myocardial injury after ischemia and reperfusion.
Animals
;
Heart Rate
;
Heart*
;
Hemodynamics
;
Ischemia
;
Korea
;
Myocardial Reperfusion Injury
;
Panax
;
Perfusion
;
Rats*
;
Reperfusion Injury
;
Reperfusion*
;
Ventricular Pressure