ABSTRACT
In an attermpt to aviod the deleterious effects of cardiopulmonary by pass such as pulmonary complication neurologic complication and renal failure off-pump CABG has been rediscovered and developed. We experienced off-pump CABG in 2 cases with unstable angina complicated with COPD and report herein the cases with review of literature.
Subject(s)
Angina, Unstable , Coronary Artery Bypass , Pulmonary Disease, Chronic Obstructive , Renal InsufficiencyABSTRACT
BACKGROUND: Immunologic and inflammatory responses of cardiopulmonary bypass(CPB) influence postoperative mortality and morbidity with multiple organ injury. It has been reported that ischemia/reperfusion induced-myocardial injury during CPB is causative of release of inflammatory cytokines such as interleukin-6(IL-6) and tumor necrosis factor-alpha (TNF-alpha). The purpose of this study was to detect the time course of the activated cytokine and troponin-T(TnT), and to examine the correlation between such parameters during CPB. MATERIAL AND METHOD: The serial samples were collected from arterial blood via radial arterial catheter in 23 patients who are underwent open heart surgery (OHS) with CPB, the IL-6, TNF-alpha and TnT were checked. RESULT: (1) IL-6, TNFalpha- and TnT concentration increased significantly during CPB with a peaking level of CPB-off (p 0.05). (2) IL-6 had highly positive correlation with aortic cross clamping time and total bypass time(r=0.80, 0.78; p 0.05, respectively). (3) There was no correlation among IL-6, TNF-alpha and TnT. CONCLUSION: In conclusion, these data showed that elevated production of serum IL-6 during CPB was attributable to ischemia/reperfusion induced-myocardial damage. IL-6 will become a new and sensitive biological marker in assessment of myocardial damage during OHS with CPB. However, further studies will be needed to apply IL-6 in more patient population.
Subject(s)
Humans , Biomarkers , Cardiopulmonary Bypass , Catheters , Constriction , Cytokines , Heart , Interleukin-6 , Mortality , Thoracic Surgery , Trinitrotoluene , Troponin T , Tumor Necrosis Factor-alphaABSTRACT
The glomus tumor is a distinctive benign neoplasm with a small painful nodule, occurs most commonly in extremities but may be found elsewhere in the body. Its occurrence in the trachea or lung parenchyme has been recognized with extreme rarity and there has not been any report, to our knowledge, of its occurrence in the main bronchial glomus tumor. We report a case of a glomus tumor in the left main bronchus in a 67-year-old man who was presented with blood-tinged sputum and dyspnea, which was completely relieved by surgical resection.
Subject(s)
Aged , Humans , Bronchi , Bronchial Neoplasms , Dyspnea , Extremities , Glomus Tumor , Lung , Sputum , TracheaABSTRACT
BACKGROUND: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery (OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. MATERIAL AND METHOD: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease (CHD) and 468 cases were acquired heart disease (AHD). The age distribution was 9 days (4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. RESULT: The CHD cases consisted of 940 ventricular septal defects (61.4%), 324 atrial septal defects (21.1%), 112 tetralogy of Fallot (7.3%), 46 pulmonary stenosis (3%), 38 endocardial cushion defects (2.5%), 15 valsalva sinus ruptures (1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles (0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements (36 aortic valve replacements (AVR), 188 mitral valve replacements (MVR), and 2 tricuspid valve replacements (TVR), among these were 71 cases of double valve replacements (AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty (TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery (CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. CONCLUSION: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6% (72/2,000).