Open heart surgery begun at 1959 in Korea. From that time to 1979, the surgery was performed below 100 cases in a year. However,that was performed above, 1,000 cases in a year from 1981. During the recent three years, i.e., 1985, 1986, and 1987, the annual operative cases were 3614,4503, and 4906, and then the mortality rates were progressively decreased to 6.2%, 5.3 %, and 5.0 %. In these time, overall mortality rate above 1 year old was 5.0 % versus that below 1 year old 17.9 9o in congenital heart diseases. These results are statistically different between two groups. Of the valvular heart disease cases, which occupied 97 % of total acquired heart disease, individual incidence was in mitral 68 %, and aortic 28%. The operative method was mainly valve replacement. Operative mortality for valve surgery in total was 4.4 %. Until 1985, bioprosthetic valve was frequently implanted but mechanical valve has been done more frequently in these days. Coronary artery bypass graft was large portion [67 * 75 %] of open heart surgery in western, but was below 1 % in Korea. However our diet patterns have been changed. Therefore we think the incidence of coronary artery disease will be increased. So we will be familiar to this field.
Gayoung Jeon;Dongjin Yang;Jongchang Jang; Jongwan Kang
Journal of the Korean Society of Radiology
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v.83
no.4
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pp.918-923
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2022
Large vessel vasculitis is characterized by chronic inflammation within the aortic wall and its major branches. The inflammation is considered to occur as a result of immune dysregulation. Hematologic malignancy is one of the rare causes of secondary vasculitis. Herein, we report a rare case of large vessel vasculitis associated with acute myeloid leukemia mimicking primary vasculitis.
Background: Protection of the brain is a major concern during thoracic aortic surgery using hypothermic circulatory arrest (HCA). This study compares the surgical outcomes of two different cerebral protection methods in thoracic aortic surgery using HCA: retrograde cerebral protection (RCP) and antegrade cerebral protection (ACP). Material and Method: We retrospectively reviewed data on 146 patients who underwent thoracic aortic surgery from May 1995 to February 2007 using either RCP (114 patients, Group 1) or ACP (32 patients, Group 2) during HCA. There were 104 dissections (94 acute and 10 chronic) and 42 aneurysms (41 true aneurysms and 1 pseudoaneurysm), and all patients underwent ascending aortic replacement. There were 33 cases of hemiarch replacement, 5 of partial arch replacement, and 21 of total arch replacement. Result: The two groups were similar in preoperative and operative characteristics, but Group 2 had more elderly (over 70 years old) patients (34.4% vs. 10.5%), more coronary artery diseases (18.8% vs. 4.4%), more total arch replacements (46.9% vs. 5.3%) and longer HCA time ($50{\pm}24$ minutes vs. $32{\pm}17$ minutes) than Group 1. The operative mortality was 4.4% (5/114) and 3.1% (1/32), the incidence of permanent neurologic deficits was 5.3% (6/114) and 3.1% (1/32), and the incidence of temporary neurologic deficits was 1.8% (2/114) and 9.4% (3/32) in Groups 1 and 2, respectively. There were no statistical differences between the two groups in operative mortality, postoperative bleeding, or neurologic deficits (permanent and temporary). Conclusion: The early outcomes of aortic surgery using HCA were favorable and showed no statistical difference between RCP and ACP. However, the ACP patients endured longer HCA times and more extended arch surgeries. ACP is the preferred brain protection technique when longer HCA time is expected or extended arch replacement is needed.
In order to investigate the effect of Lycii Radicis Cortex on hyperlipidemia, experimental studies were performed on hyperlipidemia rats. Hyperlipidemia model (controll group) was induced by 1% cholesterol fed-diet for 8 weeks. Sample I group fed with 1% cholesterol and 4% Lycii Radicis Cortex diet for 8 weeks. Sample II group fed with 1% cholesterol and 8% Lycii Radicis Cortex diet for 8 weeks. The contents of serum total cholesterol, triglyceride, free fatty acid, phospholipid, HDL-cholesterol and LDL-cholesterol were measured, and fat accumulation in liver and the change of elastic and collagenous fiber in aortic wall were observed. The results were summurized as follows ; 1. The content of total cholesterol in the serum compared with control group tended to be decreased in sample group, but did not show a significance. 2. The content of triglyceride in the serum compared with control group tended to be decreased in sample group, and then sample II group showed a significant value. 3. The content of free fat acid in the serum compared with control group tended to be decreased in sample group, and then sample II group showed a significant value. 4. The content of phospholipid in the serum compared with control group tended to be decreased in sample group, but did not show a significance. 5. The content of HDL-cholesterol in the serum compared with control group tended to be increased in sample group, and then sample I group showed a significant value. 6. The content of LDL-cholesterol in the serum compared with control group tended to be decreased in sample group, and then sample I group showed a significant value. 7. The lipophagy in liver compared with control group tended to be decreased in sample group. 8. The change of elastic and collagenous fiber lesion in tunica media of aortic wall, compared with control group tended to be decreased in sample group. According to the above results, it is assumed that Lycii Radicis Cortex has a valid effect on hyperlipidemia. Therefore, it seems to be applicable to the diseases related to hyperlipidemia.
Background: Objective Myocardin-related transcription factor (MRTF)-A is a Rho signaling-responsive co-activator of serum response factor (SRF). The purpose of this study is to investigate the role of MRTF-A and AQP1 (aquaporin 1) in pathological vascular remodeling. Materials and Methods: MRTF-A, AQP1 and neointima expression was detected both in the wire injured femoral arteries of wild-type mice and the atherosclerotic aortic tissues of $ApoE^{-/-}$ mice. Expression of ICAM-1, matrix metallopeptidase 9 (MMP-9) and integrin ${\beta}1$ were also assayed. The intercourse relationship between the molecules were investigated by interfering RNA and inhibitor assay. Results: MRTF-A and AQP1 expression were significantly higher in the wire injured femoral arteries of wild-type mice and in the atherosclerotic aortic tissues of $ApoE^{-/-}$ mice than in healthy control tissues. Both in wire-injured femoral arteries in MRTF-A knockout ($Mkl1^{-/-}$) mice and atherosclerotic lesions in $Mkl1^{-/-}$; $ApoE^{-/-}$ mice, neointima formation were significantly attenuated and the expression of AQP1 were significantly decreased. Expression of ICAM-1, matrix metallopeptidase 9 (MMP-9) and integrin ${\beta}1$, three SRF targets and key regulators of cell migration, and AQP1 in injured arteries was significantly weaker in $Mkl1^{-/-}$ mice than in wild-type mice. In cultured vascular smooth muscle cells (VSMCs), knocking down MRTF-A reduced expression of these genes and significantly impaired cell migration. Underlying the increased MRTF-A expression in dedifferentiated VSMCs were the down-regulation of microRNA-300. Moreover, the MRTF-A inhibitor CCG1423 significantly reduced neointima formation following wire injury in mice. Conclusions: MRTF-A could be a novel therapeutic target for the treatment of vascular diseases.
Kim, Hye-Won;Seo, Dong-Man;Shin, Hong-Ju;Park, Jeong-Jun;Yoon, Tae-Jin
Journal of Chest Surgery
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v.44
no.2
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pp.108-114
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2011
Background: Homograft cardiac valves and valved-conduits have been available in our institute since 1992. We sought to determine the long-term outcome after right ventricular outflow tract (RVOT) reconstruction using homografts, and risk factors for reoperation were analyzed. Materials and Methods: We retrospectively reviewed 112 patients who had undergone repair using 116 homografts between 1992 and 2008. Median age and body weight at operation were 31.2 months and 12.2 kg, respectively. The diagnoses were pulmonary atresia or stenosis with ventricular septal defect (n=93), congenital aortic valve diseases (n=15), and truncus arteriosus (N=8). Mean follow-up duration was $79.2{\pm}14.8$ months. Results: There were 10 early and 4 late deaths. Overall survival rate was 89.6%, 88.7%, 86.1% at postoperative 1 year, 5 years and 10 years, respectively. Body weight at operation, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were identified as risk factors for death. Forty-three reoperations were performed in thirty-nine patients. Freedom from reoperation was 97.0%, 77.8%, 35.0% at postoperative 1 year, 5 years and 10 years respectively. Small-sized graft was identified as a risk factor for reoperation. Conclusion: Although long-term survival after RVOT reconstruction with homografts was excellent, freedom from reoperation was unsatisfactory, especially in patients who had small grafts upon initial repair. Thus, alternative surgical strategies not using small grafts may need to be considered in this subset.
Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.
Transactions on Electrical and Electronic Materials
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v.17
no.6
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pp.375-379
/
2016
Increasing fat tissue of obese people, increases the rate of cardiovascular disease, diabetes, metabolic syndromes and dyslipidemia. An increase in the focal tissue of pancreas is a known risk factor of these diseases. Although there exists sufficient research on the diagnosis and treatment of pancreatic cancer, studies have been done on fatty pancreas. In this study, based on ultrasound imaging and using a texture characteristic of GLCM, fatty pancreas was divided into three categories: mild, moderate and severe. We compared and analyzed the three groups was by Pancreatic ultrasonography and body characteristics, serological tests, pressure and the degree of arteriosclerosis, against normal control group. The following parameters of control and test groups were measured: WC (waist circumference),BMI (body mass index), TC (total cholesterol), TG (triglyceride), HDL-C (High-density lipoprotein cholesterol) and LDL-C (Low-density lipoprotein cholesterol), SBP (systolic blood pressure), BST (Blood Sugar Test) and aortic PWV (pulse wave velocity). We observed the values correspondingly increasing fat deposition. However, ABI (Ankle Brachial pressure index) stenosis and HDL-C levels decreased with increasing fat deposit (p <0.05); a drop in these parameters are known to be harmful to the human body. The difference in texture characteristics between normal control group and pancreatic fatty group (mild, moderate, and severe) was statistically confirmed. Ultrasound imaging of pancreatic steatosis categorized the disease as mild, moderate and severe based on the characteristic texture. In conclusion, we observed on increase in metabolic syndrome, dyslipidemia, and arteriosclerosis, proportional to the degree of pancreatic fat deposition. The escalation of these diseases was confirmed and was directly related with predictors of cardiovascular diseases.
Objectives: Lonicerae flos (LF), a dried flower part of Lonicera japonica Thunb., has been widely used in Korean medicine as anti-inflammatory and antioxidative agent. The purpose of this study was to determine the cardioprotective effects of LF, through potential antioxidant effects, on the pressure overload (PO)-induced heart failure (HF) in C57BL/6 mice after transverse aortic constriction (TAC) surgery. Methods: Resveratrol (10 mg/kg body weight) or LF (125, 250 or 500 mg/kg body weight) was orally administered, once daily for 14 days, starting 14 days after TAC surgery. Changes in the mortality, body weights, heart weights, histopathology of the heart, and antioxidant defense systems of the heart were analyzed. Results: Marked and noticeable increases of heart weights, mortalities, and hypertrophic, focal, and lytic fibrotic histological changes in the LVs were observed, with destruction of heart antioxidant defense systems after surgery. However, HF signs, induced by TAC surgery through PO, and destruction of heart antioxidant defense systems were significantly and dose-dependently inhibited by 14 days of maintained oral treatment with LF 500, 250 or 125 mg/kg. Treatment with 250 mg/kg LF was comparable to treatment with 10 mg/kg resveratrol. Conclusions: The results in this study suggest that oral administration of LF favorably relieves PO-induced HF following TAC, through increase of heart antioxidant defense systems. The overall effects of 250 mg/kg LF were similar to those of 10 mg/kg resveratrol. More detailed mechanistic studies should be conducted in the future, with screening of the biologically active compounds in LF.
Between April, 1984 and September, 1988, 459 patients underwent cardiovascular surgery at the Yeungnam University Hospital. Of these, 355 cases were open heart surgeries and 104 cases were non-open heart surgeries. There were 237 patients of acyanotic congenital cardiac anomalies, 40 patients of cyanotic congenital cardiac anomalies, and 85 patients of acquired heart diseases. The sex ratio of cardiovascular diseases was represented as 1:1.3 in male and female. The age distribution was ranged from 1 day to 65 years old. The common congenital cardiovascular anomalies were ventricular septal defect(38.7%), patent ductus arteriosus(25.5%), atrial septal defect(20.7%), Tetralogy of Fallot(8.3%), and pulmonary stenosis(2.4%) in order of frequency. Among 87 acquired cardiovascular diseases, 81 patients underwent operation for cardiac valvular lesions. 51 patients had mitral valve replacement and 13 patients had aortic valve replacement and 17 patients had double valve replacement. The overall mortality of cardiovascular surgery was 3.3% and mortality of open heart surgery was 3.9%.
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