• 제목/요약/키워드: Angina pectoris

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Analysis of Interval-censored Survival Data from Crossover Trials with Proportional Hazards Model (교차계획 구간절단 생존자료의 비례위험모형을 이용한 분석)

  • Kim, Eun-Young;Song, Hae-Hiang
    • The Korean Journal of Applied Statistics
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    • v.20 no.1
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    • pp.39-52
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    • 2007
  • Crossover trials of new drugs in the treatment of angina pectoris, which frequently use treadmill exercise test for the assessment of its efficacy, produce censored survival times. In this paper we consider analysis approaches for censored survival times from crossover trials. Previously, a stratified Cox model for paired observation and nonparametric methods have been presented as possible analysis methods. On the other hand, the differences of two survival times would produce interval-censored survival times and we propose a Cox model for interval-censored data as n alternative analysis method. Example data is analyzed in order to compare these different methods.

Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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Left ventricular aneurysm (Two cases report) (좌심실에 발생한 진성심실류 (2례 보고))

  • 이철세
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.175-183
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    • 1983
  • Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

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Factors Influencing Cardiopulmonary Resuscitation Performance on a Stranger (일 지역 주민의 심폐소생술 수행에 미치는 영향요인)

  • Kim, Hyun-Sook;Uhm, Dong-Choon;Hong, Sun-Woo
    • The Journal of Korean Academic Society of Nursing Education
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    • v.16 no.2
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    • pp.339-346
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    • 2010
  • Purpose: Bystander cardiopulmonary resuscitation (CPR) improves survival. However, there have been few studies on the performance of bystander CPR in Korea. This study was done to identify the reasons for being unwilling to perform CPR, and to investigate the factors associated with performing CPR on a stranger in an emergency situation. Method: The participants in this study were 444 local residents. Data were collected by using self-reported questionnaires from May 1 to June 30, 2010. For data analysis, descriptive statistics and multiple logistic regression were performed using SAS version 9.1. Result: Only 32.2% of respondents reported being willing to perform CPR on a stranger. The major reason for not being willing to perform CPR on a stranger was "have no confidence to perform CPR well". From multiple logistic regression analysis, statistically significant predictors of CPR performance on a stranger were found to be a higher educational level (OR=6.11, 95% CI 1.46-25.52), neighbors with angina pectoris or myocardial infarction (OR=6.65, 95% CI 3.93-11.24), and having confidence of performing CPR (OR=3.02, 95% CI1.78-5.14). Conclusion: CPR education (including automatic external defibrillator) should be offered to family members and neighbors. In addition, the Good Samaritan Law must be given wider publicity at the national level.

Preparation and Dissolution Characteristics of Sustained Release Pellets Containing Isosorbide Dinitrate (질산 이소소르비드가 함유된 서방형 펠렛의 제조 및 용출 특성)

  • Lee, Gye-Won;Kim, Hak-Hyung;Ryu, Sung-Kyun
    • Journal of Pharmaceutical Investigation
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    • v.38 no.6
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    • pp.381-385
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    • 2008
  • Isosorbide dinitrate is an oral assiatant therapy agent of angina pectoris, myocardial infarction and congestive heart failure. The objective of this study was to formulate sustained release containing isosorbide dinitrate and assess their formulation variables. Pellets were prepared by fluid bed process and consist of drug layer and membrane layer. The pellets were coated with ethylcellulose along with $5{\sim}15%$ of plasticizer such as triacetin and diethyl butylrate. In vitro evaluation study was performed by comparative dissolution test between test and reference isosorbide dinitrate preparation. We could prepare sustained pellets of isosorbide dinitrate by fluid bed process which were reduced process time and had high content. The pellet coated with 1% ethylcellulose and triacetin(l5%) had a similar dissolution behavior compare to reference isosorbide dinitrate preparation controlling initial dissolution and those of dissolution at 30 min were 17.25 and 17.09%, respectively. Difference factor and similarity factor were $0{\sim}15$ and $50{\sim}100$ and there was no significant difference in bioequivalence between formulations. It might be concluded that our sustained release pellet of isosorbide dinitrate could be an alternatively delivery system to reference drug preparation.

Protective Effects of Verapamil against H2O2-Induced Apoptosis in Human Lens Epithelial Cells

  • Wang, Zhuo;Wang, Dan;Li, Yan;Zhang, Xiuli
    • Biomolecules & Therapeutics
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    • v.22 no.6
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    • pp.553-557
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    • 2014
  • Verapamil is used in the treatment of hypertension, angina pectoris, and atrial fibrillation. Recently, several studies have demonstrated that verapamil increased the optic nerve head blood flow and improved the retrobulbar circulation. All these show that verapamil is potentially useful for ophthalmic treatment. Thus, the aim of this study is to investigate whether verapamil could protect human lens epithelial cell (HLEC) from oxidative stress induced by $H_2O_2$ and the cellular mechanism underlying this protective function. The viability of HLEC was determined by the MTT assay and apoptotic cell death was analyzed by Hoechst 33258 staining. Moreover, Caspase-3 expression was detected by immunocytochemistry and flow cytometry analysis. We also detected Caspase-3 mRNA expression by reverse-transcription-polymerase chain reaction and the GSH content in cell culture. The results showed that oxidative stress produced significant cell apoptotic death and it was reduced by previous treatment with the verapamil. Verapamil was effective in reducing HLEC death mainly through reducing the expression level of apoptosis-related proteins, caspase-3, and increasing glutathione content. Therefore, it was suggested that verapamil was effective in reducing HLEC apoptosis induced by $H_2O_2$.

Successful Outcome of an Elderly Patient with Small Cell Lung Cancer with only Alternative Treatments: A Case Report

  • Lee, Sanghun;Joo, Jeonghyun;Chon, Songha
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.171-176
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    • 2018
  • Background: Small cell lung cancer (SCLC) tends to grow more rapidly and spread much faster than non-small cell lung cancer (NSCLC). A concurrent combination of chemotherapy and thoracic radiotherapy is suggested as the standard conventional treatment, but it is more challenging for elderly patients having pulmonary and cardiovascular comorbidities. Case presentation: Here we present a case of an 80-year-old male, current smoker diagnosed with SCLC in limited stage T3N0M0 (36mm right upper lobe, satellite nodule) in Dec, 2015. The standard concurrent chemoradiotherapy was not available for his comorbidities, which included chronic obstructive pulmonary disease (COPD) and angina pectoris. Furthermore, he and his family refused the recommended chemotherapy or radiotherapy exclusively. Alternatively, he received various non-conventional treatments including local radiofrequency hyperthermia, mistletoe, and Traditional Korean medicine including acupuncture, moxibustion and herbs since Jan. 2016. Despite the progression in primary tumor size, there have been no other distant relapse so far, and the patient has been in stable condition ever since. Conclusion: We suggest that a combination of various alternative treatments could be a candidate for elderly patients intolerable to conventional cytotoxic treatments.

Accidental Choking Deaths with Octopus minor and Octopus ocellatus (낙지와 주꾸미에 의한 사고성 기도막힘질식사)

  • Lee, Seok Joo;Choi, Minsung;Ha, Hongil
    • The Korean Journal of Legal Medicine
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    • v.42 no.4
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    • pp.168-171
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    • 2018
  • In Korea, small octopus (Octopus minor) and webfoot octopus (Octopus ocellatus) are food items and fatal laryngeal choking due to ingestion of live octopus is not uncommon. We recently encountered two autopsy cases of accidental choking on small octopus and webfoot octopus. Case 1 involved a 58-year-old fisherman who ingested two live webfoot octopuses in his fishing boat and collapsed. He was immediately taken to the hospital but died. During autopsy, one of the webfoot octopuses was found between his pharynx and esophagus; it was obstructing the epiglottis and upper esophagus. His blood alcohol concentration was 0.140%. Case 2 involved a 55-year-old man who ingested an intact body part of a small octopus and was found dead in his house. He had a history of cerebral infarction and angina pectoris. During autopsy, an intact body part of the small octopus was found to be lodged in the laryngeal inlet.

Whitening Effects of Crataegus pinnatifida bunge Fruit Extracts (크라테구스 열매 추출물의 미백효능)

  • Hyunji Kim;Juhee Song;Kunjung Chung;Minkyung Jang;Kyung-A Choi;June Hyun Kim
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2022.09a
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    • pp.97-97
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    • 2022
  • The fruit of the Crataegus pinnatifida bunge has been known to have a role as a digestive stimulant, and is used for postpartum abdominal pain and women's menstrual pain. It is used for coronary artery disease, angina pectoris, hypertension and hyperlipidemia. Ascorbic acid, hydroquinone, retinoids, alpha-hydroxy acids, kojic acid, azelaic acid have been used for cosmetic whitening and medical depigmentation. To determine whether Crataegus pinnatifida bunge fruit also has whitening and depigmentation effect, tyrosinase inhibition assay was performed with American Crataegus pinnatifida Bunge ethanol extracts, Korean Crataegus pinnatifida Bunge (Cra) ethanol extracts and Arbutin as a positive control as previously described by Korean FDA guideline. Korean Cra fruit ethanol extracts were 1.87 fold more inhibitory function to tyrosinase activity than American Cra in the experimental condition that inhibitory function to tyrosinase activity of Korean Cra Arbutin is 81.8% when compared to that of the standard control Arbutin as 100%. These results suggest that ethanol extracts of Crataegus pinnatifida bunge have significant whitening effects and may provide the basis for development of cosmetic whitening agent and medical depigmentation applications.

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Coronary Computed Tomography Angiography for the Diagnosis of Vasospastic Angina: Comparison with Invasive Coronary Angiography and Ergonovine Provocation Test

  • Jiesuck Park;Hyung-Kwan Kim;Eun-Ah Park;Jun-Bean Park;Seung-Pyo Lee;Whal Lee;Yong-Jin Kim;Dae-Won Sohn
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.719-728
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    • 2019
  • Objective: To investigate the diagnostic validity of coronary computed tomography angiography (cCTA) in vasospastic angina (VA) and factors associated with discrepant results between invasive coronary angiography with the ergonovine provocation test (iCAG-EPT) and cCTA. Materials and Methods: Of the 1397 patients diagnosed with VA from 2006 to 2016, 33 patients (75 lesions) with available cCTA data from within 6 months before iCAG-EPT were included. The severity of spasm (% diameter stenosis [%DS]) on iCAGEPT and cCTA was assessed, and the difference in %DS (Δ%DS) was calculated. Δ%DS was compared after classifying the lesions according to pre-cCTA-administered sublingual nitroglycerin (SL-NG) or beta-blockers. The lesions were further categorized with %DS ≥ 50% on iCAG-EPT or cCTA defined as a significant spasm, and the diagnostic performance of cCTA on identifying significant spasm relative to iCAG-EPT was assessed. Results: Compared to lesions without SL-NG treatment, those with SL-NG treatment showed a higher Δ%DS (39.2% vs. 22.1%, p = 0.002). However, there was no difference in Δ%DS with or without beta-blocker treatment (35.1% vs. 32.6%, p = 0.643). The significant difference in Δ%DS associated with SL-NG was more prominent in patients who were aged < 60 years, were male, had body mass index < 25 kg/m2, and had no history of hypertension, diabetes, or dyslipidemia. Based on iCAG-EPT as the reference, the per-lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of cCTA for VA diagnosis were 7.5%, 94.0%, 60.0%, 47.1%, and 48.0%, respectively. Conclusion: For patients with clinically suspected VA, confirmation with iCAG-EPT needs to be considered without completely excluding the diagnosis of VA simply based on cCTA results, although further prospective studies are required for confirmation.