• 제목/요약/키워드: Angina

검색결과 302건 처리시간 0.022초

관상동맥 우회수술후 이식혈관의 개존 (Patency Rate of Grafts after Coronary Artery Bypass Surgery)

  • 노환규
    • Journal of Chest Surgery
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    • 제25권1호
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    • pp.42-48
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    • 1992
  • Clinical improvement after coronary artery bypass surgery depends on the complete revascularization and patency of graft vessels. Patency rate and the factors influencing the patency were studied by examining 134 grafts in 55 patients at a mean follow-up of 22.8$\pm$4.2 months, range 15 days and 108 months. Serial studies were performed on 7 patients with 18 grafts. The over-all patency rate was 80.6%, and the rate more than 5 years after surgery was 50.0% with mean interval of 81 months. Patency rate of patients who had taken both aspirin and dipyridamole was higher than of patients who had been treated with aspirin only[80.5% vs 56.5%]. The average serum triglyceride level of patients who had graft stenosis or occlusion in at least one site was significantly higher than that of patients in whom all grafts were patent[262.1mg% vs 174.8mg%]. Patency rate of grafts in patient who had angina was 73.2% and in patients without angina 79.2%. 6 patients underwent successful percutaneous transluminal angioplasty for narrowed or occluded grafts.

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관상동맥우회술 환자에서의 심근관류점수제에 대한 연구: 완전혈관재생술의 평가 (Myocardial Perfusion Scoring System in Coronary Bypass Grafting - Estimation of Completeness -)

  • 채헌;백완기;안혁;김용진;노준량;김종환;서경필
    • Journal of Chest Surgery
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    • 제24권9호
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    • pp.881-889
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    • 1991
  • The ideal goal of the coronary artery bypass surgery is complete revascularization. To estimate the numerical degree of completeness of revascularization, the following formula was used in 50 patients having aorta-coronary bypass grafting for the treatment of unstable angina. myocardial perfusion score of revascularized area Degree of Completeness = ----------------------------------------------------------------------------- x100[%] preoperative myocardial perfusion score Randomized patients who underwent revascularization procedures in 19Hb were compared with the patients who received similar elective operation each year from 1988 through 1991. To obtain these data, the patients aged 38 ~ 75[mean 54$\pm$9.1years], composed of 31 males and 19 females were randomly sampled. The number of grafts per patient increased from 2.30 in 1986, to 3.07 in 1988 - 89, to 3.21 in 1990, and to 3.50 in 1991. [0.05 The degree of completeness improved from 75.4% to 81.4%, 91.6% and 88.6% respectively. It improved significantly in the last two years, [P<0.05, Mann-Whitney U test] At a follow-up of three months, 90 percent[45/50] of patients remained angina, free, 6 percent[3/50] had residual angina, and 4 percent[2/50] died. The last two patients degree of completeness corresponded to 43% and 30% respectively As a conclusion, the degree of completeness seems to improve year by year, and to have close relationship with the clinical results.

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패혈증으로 진행된 치성 감염 : 증례보고 (SEPSIS FROM ODONTOGENIC INFECTION : A CASE REPORT)

  • 오성섭;박은진;김일규;최진호;김형돈;오남식
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제25권4호
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    • pp.375-378
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    • 1999
  • 우수한 항생제 요법이후 치성 감염으로 인한 Ludwig's angina의 합병증으로 인한 사망은 극히 드문 것으로 알려져 왔다. 본 교실에서는 고혈압의 기왕력을 지닌 57세 여환이 하악 전치부의 치근단 농양을 원인으로 하는 좌측 협간극의 감염으로 인하여 개구장애와 동통을 주소로 내원하여 입원치료중, Ludwig's angina 및 심경부감염으로 확산되고 입원 10일째 패혈증과 성인 호흡장애 증후군(ARDS)및 산발성 혈관내 응고증(DIC)의 진단하에 사망한 증례를 통하여 패혈증의 소견과 진단 및 그에 따른 처치 등에 대한 지견을 얻었기에 진단과 예방에 도움을 주고자 문헌고찰과 함께 보고하는 바이다.

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관상동맥 우회술후 출혈경향과 수혈양상 (Bleeding Tendency and Transfusion Feature after CABG)

  • 이재원;김상필;송명근
    • Journal of Chest Surgery
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    • 제31권6호
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    • pp.581-585
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    • 1998
  • 술후자가수혈은 수혈부작용없이 혈액보존을 할 수 있는 방법으로 알려져있다. 불안정성 협심증에 대한 관상동맥우회술 후에 술후자가수혈을 채용하면 동종수혈을 얼마나 줄일 수 있을 지를 알아보고자 이 환자군을 대상으로 출혈경향과 동종수혈양상을 관찰하였다. 1997년 8월부터 10월까지의 기간에 시행한 관상동맥우회술 환자 중, 불안정성 협심증인 26명을 대상으로 후향적으로 조사한 결과 90%의 환자가 평균 2.4단위의 동종수혈을 받았고 85%의 환자에서 수술당일 중환자실에서 혈액이 투여되었으며 다수에서 빈혈의 교정이 아니고 혈량유지를 위하여 수혈이 이루어졌다. 출혈은 술후 5시간까지 평균 340cc였고 69%(18명)에서 200cc이상의 출혈을 보여 이 환자에게 자가수혈을 할수 있을 것으로 사료되었다. 결론적으로 여러 가지 혈액보존법의 채용에도 불구하고 90%의 환자에서 동종수혈이 이루어졌으며 그 중 다수에서 불필요한 수혈이 있었음을 알 수 있었으며 이를 해결하는 한 방법으로 수술직후 출혈이 있는 시기에 어떤 종류의 혈액이 필요하며 따라서 수술후 자가수혈을 채용하면 동종수혈을 줄이는데 기여할 수 있을 것으로 보인다.

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폐절제와 관상동맥 우회술의 동반 수술 치험 3예 (Combined Surgery of Pulmonary Resection and Coronary Artery Bypass Grafting (CABG))

  • 김진선;이영탁;김진국;김관민;최용수;성기익;심영목
    • Journal of Chest Surgery
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    • 제38권3호
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    • pp.253-257
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    • 2005
  • 원발성 폐암의 환자에서 협심증을 동반하고 있는 경우 그 동안 관상동맥우회술을 폐수술 전에 먼저 시행하여 교정하는 단계적인 방법이 주로 이용되었다. 그러나 최근 관상동맥우회술과 폐절제를 동시에 시행하여 단계적 수술 방법의 단점으로 지적되고 있는 두 번의 전신마취, 두 개의 수술상처, 폐 절제의 지연 등을 감소시키려는 경향이 늘고 있고, 좋은 성적을 보고하고 있다. 본원에서도 국내 최초로 폐절제와 관상동맥우회술을 동시에 시행하여 수술 후 양호한 경과를 보이면서 현재까지 추적 관찰하는 중에 암과 협심증의 재발이 없음을 관찰하였기에 보고하는 바이다.

관동맥 협착증의 외과적 치료 (A Surgical Treatment of Coronary Artery Occlusive Disease [A Report of 41 Cases])

  • 조범구
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.220-231
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    • 1985
  • In selected patients with occlusive lesions of coronary arteries, aortocoronary bypass grafting has been effective in reducing anginal symptoms and in increasing the patients` longevity. Between May, 1977, and December, 1983, 41 patients with coronary occlusive disease received aortocoronary bypass surgery at Yonsei University Medical Center in Seoul. Thirty-three were male and 8 were female. Their ages ranged from 33 to 70 years [average 531.6 years]. Of the 41 patients, 11 suffered from stable angina, 30 suffered from unstable angina and 4 suffered from a variant type of angina. Eleven patients had 1 diseased vessel, 11 patients had 2 diseased vessels, 19 patients had 3 diseased vessels, and 5 patients had a diseased left main coronary artery. A single graft was placed in 5 patients, a double graft was placed in 17 patients, a triple graft was placed in 11 patients and a quadruple graft was placed in 8 patients. Nineteen patients received a sequential graft [40 sites of 20 vessels]. The average internal diameter of the grafted distal coronary artery was 2.380.15, 1.630.13 mm on the left side and 3.200.20, 1.830.21 mm on the right side. Two operative deaths occurred in the early years of our experience. The mortality rate was 4.87% and there were no late deaths. Of the 39 survivors, 30 [76.9%] were Functional Class I [free of symptoms without medication], 7 [17.9%] were Functional Class II and only 2[5.2%] were Functional Class III during the follow up period [653.75 patient-months]. On the basis of this experience, we conclude that coronary artery occlusive disease is occurring in increasing numbers in Korea. Therefore, a concerted effort is needed to detect this disease and to manage the increasing number of patients suffering from it.

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우리나라 성인의 구강질환과 만성질환의 관련성 (The association of oral diseases and chronic diseases in Korean adult population)

  • 천혜원;유미선;최미혜
    • 한국치위생학회지
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    • 제12권2호
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    • pp.235-249
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    • 2012
  • Objectives : The purpose of this research is to use data from the third year of the 4th National Health and Nutrition Examination Survey to study relationship between oral disease and chronic disease that generally persist from 6 months to over a year, or more specifically, circulatory disease, diabetes, and osteoporosis. Methods : Of the data from the third year of the 4th National Health and Nutrition Examination Survey, 7,893 adults over 19 years old who completed medical examination, health survey, and nutrition survey were selected as the final research subjects. Relationship between chronic disease and oral disease was analyzed by cross tabulation (2-test) and logistic regression analysis using SPSSWIN ver 18.0. Results : 1. Differences in the rate of prevalence of periodontal disease and the rate of prevalence of missing teeth were statistically significant with respect to age, gender, marital status, education level, residential area, income level, and occupation. Rate of prevalence of dental caries was statistically significant with respect to age, education level, and income level. 2. After examining the relationship between existence of chronic disease as diagnosed by doctor with oral disease, rate of prevalence of periodontal disease and missing teeth, hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis showed statiscally significant difference. 3. Examination of rate of prevalence of chronic disease with respect to oral disease, periodontal disease and missing teeth exerted statistically significant influence on hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis (p<0.05), while dental caries did not have statistically significant effect. 4. Analysis of coupling effect of periodontal disease and missing teeth on chronic disease showed that they were related in all chronic diseases examined in this study (hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis) (p<0.05). Conclusions : Periodontal disease and missing teeth were found to increase the rate of prevalence of chronic disease.

협심증이 의심되어 운동부하검사를 받은 여성들의 흉통에 관한 내용분석 (Content Analysis of Experiences of Chest Pain in Women Who Underwent the Treadmill Test with an Impression of Angina Pectoris)

  • 최명애;이명선;안경애;임은옥
    • 성인간호학회지
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    • 제14권3호
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    • pp.459-469
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    • 2002
  • Purpose: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. Method: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test Result: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. Conclusion: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.

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Preoperative Levels of Uric Acid and Its Association to Some Perioperative Parameters in the Patients with Unstable Angina or Myocardial Infarction

  • Kang, Chan-Sik;Seok, Seong-Ja;Choi, Hwa-Sik;Kim, Dae-Sik;Choi, Seok-Cheol;Moon, Seong-Min
    • 대한의생명과학회지
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    • 제17권2호
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    • pp.113-122
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    • 2011
  • Several studies have reported a relation between serum levels of uric acid and a wide variety of cardiovascular conditions. But, the relationship between serum levels of uric acid and coronary artery disease (CAD) is still controversial. The present study was retrospectively designed to investigate whether CAD can be stratified by the level of uric acid and there are the relationships between preoperative levels of uric acid and perioperative biochemical markers in fifty-adult patients that underwent coronary artery bypass grafting surgery (CABG) and twenty-normal subjects. They were divided into the control, the unstable angina (UA-group) and the myocardial infarction group (MI-group). In preoperative levels of uric acid, the MI-group was higher than control and the UA-group. The MI-group had significantly higher correlations than the UA-group between preoperative levels of uric acid and left ventricular ejection fraction, cardiac markers (creatine kinase, lactate dehydrogenase and brain natriuretic peptide), renal markers (blood urea nitrogen and creatinine) or total leukocyte levels. At postoperative periods, the MI-group had higher relationships of uric acid with aspartate aminotransferase, blood urea nitrogen or creatinine levels. Although there was not statistically significant, the UA-group tended to have higher correlation coefficients than the MI-group between preoperative levels of uric acid and intensive care unit-stay (ICU), or postoperative mechanical ventilation time. These results reflect that increased levels of serum uric acid may be a tool for the diagnosis of coronary heart disease and may be considered as a good predictor in assessing the cardiac and renal functions in patients with myocardial infarction or unstable angina at the preoperative period. However, further studies should be performed in a large patient population.