• Title/Summary/Keyword: 치료적 초음파

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The Role of B-type Natriuretic Peptide in Predicting Postoperative Complications and Outcomes in Patients Undergoing Coronary Artery Bypass Graft (관상동맥 우회술 환자의 술 후 합병증 예견에 대한 BNP의 역할)

  • Jung, Tae-Eun;Lee, Jang-Hoon;Do, Hyung-Dong;Han, Sung-Sae;Lee, Dong-Hyup
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.55-60
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    • 2008
  • Background: Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure. The aim of our study was to investigate whether preoperative and postoperative BNP levels could predict postoperative complications and outcomes in patients after coronary artery bypass graft (CABG). Material and Method: Data was collected prospectively on 30 patients (M/F=19/11, age $60.0{\pm}9.6$ years) undergoing conventional CABG during a 1-year period beginning on January 1, 2005. Patients underwent off-pump CABG, and combined surgery was excluded. The BNP assay was performed preoperatively, immediate postoperatively at the intensive care unit (ICU), and 1, 3, 5, and 7days postoperatively. Result: Preoperative BNP levels significantly correlated with preoperative echocardiographic ejection fraction and an ICU stay of 5 days or more (r=-0.4, p=0.028; r=0.39, p=0.031, respectively). A preoperative BNP cut-off value above 263 pg/mL demonstrated high specificity (90.5%) for predicting postoperative complications using the receiver operating characteristics curves. Preoperative and postoperative (7 days) BNP levels were different depending on the abscence (mean BNP=$99{\pm}23\;pg/mL$ vs. $296{\pm}74\;pg/mL$, p<0.05) and presence (mean BNP=$212{\pm}29\;pg/mL$ vs. $408{\pm}23\;pg/mL$, p<0.01). Conclusion: Preoperative BNP levels >263 pg/mL predict postoperative complications in patients receiving CABG.

Antioxidant and anti-inflammatory activities of extracts from Ledum palustre L. (백산차 추출물의 항산화 및 항염증 활성)

  • Kim, Se Gie
    • Food Science and Preservation
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    • v.24 no.7
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    • pp.1025-1033
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    • 2017
  • In this study, Ledum palustre L. was extracted by 4 different methods (LPW, hot water extraction; LPA, autoclave extraction; LPU, ultrasonification extraction; LPE, 70% ethanol extraction) and LPE was fractionated by using polarity difference of each solvent and used as 4 samples (LPE/H, the n-hexane layer; LPE/E, the EtOAc layer; LPE/B, the n-BuOH layer; LPE/W, the $H_2O$ layer). Antioxidant activities of Ledum palustre L. extracts were measured by DPPH and ABTS. As a result, the DPPH and ABTS radical scavenging showed high activities with LPE (82.3%, 99.8%) and LPE/E (91.8%, 99.6%) at the concentration of $1,000{\mu}g/mL$. The anti-inflammatory activities of LPE and LPE/E were measured by the inhibitory activity against NO, $PGE_2$, TNF-${\alpha}$, IL-$1{\beta}$ and IL-6 production on LPS-stimulated Raw 264.7 macrophages. As a result of MTT assay, cell viabilities of LPE and LPE/E were more than 90% at $25{\mu}g/mL$. NO and $PGE_2$ productions were inhibited by LPE (NO: 50%, $PGE_2$: 70%) and LPE/E (NO: 57%, $PGE_2$: 73%) at the concentration of $25{\mu}g/mL$. The inhibition activities against TNF-${\alpha}$, IL-$1{\beta}$, IL-6 production were 24%, 47% and 40% at the concentration of $25{\mu}g/mL$ of LPE. In particular, LPE/E showed 51%, 57% and 62% inhibition activities at the same concentration, respectively. From the above results, it can be concluded that $1,000{\mu}g/mL$ of LPE and LPE/E have the high antioxidant activities similar with Vitamin C, and $25{\mu}g/mL$, the low concetration of LPE and LPE/E have excellent anti-inflammatory activities. Therefore, if more research about anti-aging, whitening and antimicrobial activity of Ledum palustre L. extracts is carried out in the future, it will be possible to use them as effective materials for the prevention and treatment of inflammatory diseases and in the areas of functional foods and cosmetics.

Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction (중등도 이상의 좌심기능부전 환자에서 승모판성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.812-819
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    • 2003
  • Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

Analysis of Recurred Mitral Regurgitation after Mitral Repair according to Procedure or Valve Related Causes (승모판막 성형술 후 재발의 원인에 대해 술기와 판막 요인에 대한 분석)

  • Shin Hong Ju;Yoo Dong Gon;Lee Yong Jik;Park Soon Ik;Choo Suk Jung;Song Hyun;Chung Cheol Hyun;Song Meong Gun;Lee Jae Won
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.132-138
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    • 2005
  • Background: Mitral valve repair (MVP) is the optimal procedure for mitral regurgitation (MR), however, failure and subsequent reoperations are the limitations. The current study assessed the procedure in relation to the primary valve related causes of recurrent MR. Material and Method: MR was treated in 493 patients undergoing MVP from January of 1994 to January of 2002. The causes of MR were degenerative $(n=252,\;51.5\%),$ rheumatic $(n=156,\; 31.6\%),$ and others $(n=85,\; 16.9\%).$ Surgery comprised 446 ring annuloplasties $(90.5\%),$ 227 new chordae formations $(46\%),$ 125 quadriangular resections $(25.3\%),$ 28 chordae transfers $(5.7\%),$ and 8 Alfieri's stitches $(1.6\%).$ The mean follow up was $29.04\pm22.81$ months. Result: There were 5 early $(1.01\%)$, and 5 late deaths $(1.01\%).$ The reoperation rate was $1.42\%$. There were 45 $(9.1\%)$ recurrent MR (grade III or IV). Of these, 24 were procedure related including incomplete repair (n=14), discordant new chordae length (n=8) and others (n=2). In 21 patients, the cause was valve related including rheumatic disease progression (n=10), recurrent chordae elongation or prolapse (n=5) and others (n=6). Severe MR was higher after incomplete repair (p < 0.001), and valve related failure strongly correlated with rheumatic progression (p < 0.05). Conclusion: Since completeness of operation is the prime risk factor that determine the repair durability, intra-operative assessment of the initial repair with trans-esophageal echocardiography is essential.

Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.