• 제목/요약/키워드: CHD

검색결과 178건 처리시간 0.026초

Practical stepwise approach to rhythm disturbances in congenital heart diseases

  • Huh, June
    • Clinical and Experimental Pediatrics
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    • 제53권6호
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    • pp.680-687
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    • 2010
  • Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.

Needs for Post-hospital Education among Parents of Infants and Toddlers with Congenital Heart Disease

  • Lee, Bo Ryeong;Koo, Hyun Young
    • Child Health Nursing Research
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    • 제26권1호
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    • pp.107-120
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    • 2020
  • Purpose: This study was conducted to investigate the educational needs of parents of infants and toddlers with congenital heart disease (CHD) after hospital discharge. Methods: Qualitative content analysis was conducted of in-depth interviews of eight parents, and the results of an online survey of 171 parents were analyzed quantitatively. Results: Only 16.4% of parents reported that they had received education after hospital discharge on how to provide care for a child with CHD at home. The main reason why parents did not receive education on this topic was that they did not have sufficient opportunities or information (75.5%). In addition, 97.1% of parents stated that they needed educational programs that would be available at home after discharge. In terms of specific educational content, parents expressed the highest needs for education on the symptoms of CHD and ways to cope with them, the prognosis of CHD, and the growth and development of infants and toddlers with CHD. Conclusion: The study showed that parents' educational needs were high in many ways. However, the information and educational opportunities offered after discharge were insufficient compared to those needs. Further research is needed to develop post-hospital educational programs that meet their needs.

Respiratory syncytial virus prevention in children with congenital heart disease: who and how?

  • Kim, Nam-Kyun;Choi, Jae-Young
    • Clinical and Experimental Pediatrics
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    • 제54권5호
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    • pp.197-200
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    • 2011
  • Respiratory syncytial virus (RSV) is a major cause of respiratory infection in children. Most of the pediatric population have RSV infection before the age of 2, and recurrent infections are common even within one season. Chronic lung disease, prematurity, along with congenital heart disease (CHD) are major risk factors in severe lower respiratory infection. In hemo-dynamically significant CHD patients with RSV infection, hospitalization is usually needed and the possibility of treatment in intensive care unit and the use of mechanical ventilator support are known to increase. Therefore the prevention of RSV infection in CHD patients is mandatory. The current standard for RSV prevention is immunoprophylaxis by palivizumab. Immunoprophylaxis is recommended monthly in hemodynamically significant CHD patients, up to 5 months. Motabizumab, a second generation drug and newly developing RSV vaccines are also expected to play a key role in RSV prevention in the future. The prophylaxis of RSV infection in CHD patients is cost-effective in both the medical aspect of the patients as well as the socio-economic aspect. Therefore an effort to promote prevention should be made by not only the family of the patients but also by the government.

Gender determination in parrots from Korean zoos using chromo-helicase-DNA binding protein 1 (CHD1) gene fragments

  • Kim, Jung-il;Do, Thinh Dinh;Choi, Tae-June;Yeo, Yonggu;Kim, Chang-Bae
    • 환경생물
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    • 제38권3호
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    • pp.350-354
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    • 2020
  • Many parrots are considered endangered species due to threats from human activities. Gender determination is of great importance for biological studies and the conservation of endangered parrots. However, like other birds, gender determination in parrots is hindered due to the lack of external dimorphism between males and females. A molecular approach using the chromo-helicase-DNA binding protein 1 (CHD1) gene is commonly used for sexing birds. This study aimed to determine the gender of parrots from Korean zoos based on amplification and visualization of the partial CHD1 gene. The samples of 13 parrot species were collected from three different zoos in Korea and the extracted DNA templates were amplified using CHD1 gene primers. The gender of 27 samples of 13 species was determined by visualizing the PCR products on an agarose gel. While male parrots were indicated by a single band, female parrots were indicated by double bands. The findings provide additional information, which might be helpful for the management and care of parrots in Korean zoos.

Effects of sleep deprivation on coronary heart disease

  • Wei, Ran;Duan, Xiaoye;Guo, Lixin
    • The Korean Journal of Physiology and Pharmacology
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    • 제26권5호
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    • pp.297-305
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    • 2022
  • The presence of artificial light enables humans to be active 24 h a day. Many people across the globe live in a social culture that encourages staying up late to meet the demands of various activities, such as work and school. Sleep deprivation (SD) is a severe health problem in modern society. Meanwhile, as with cardiometabolic disease, there was an obvious tendency that coronary heart disease (CHD) to become a global epidemic chronic disease. Specifically, SD can significantly increase the morbidity and mortality of CHD. However, the underlying mechanisms responsible for the effects of SD on CHD are multilayered and complex. Inflammatory response, lipid metabolism, oxidative stress, and endothelial function all contribute to cardiovascular lesions. In this review, the effects of SD on CHD development are summarized, and SD-related pathogenesis of coronary artery lesions is discussed. In general, early assessment of SD played a vital role in preventing the harmful consequences of CHD.

Application of CRISPR-Cas9 gene editing for congenital heart disease

  • Seok, Heeyoung;Deng, Rui;Cowan, Douglas B.;Wang, Da-Zhi
    • Clinical and Experimental Pediatrics
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    • 제64권6호
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    • pp.269-279
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    • 2021
  • Clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9 (CRISPR-Cas9) is an ancient prokaryotic defense system that precisely cuts foreign genomic DNA under the control of a small number of guide RNAs. The CRISPR-Cas9 system facilitates efficient double-stranded DNA cleavage that has been recently adopted for genome editing to create or correct inherited genetic mutations causing disease. Congenital heart disease (CHD) is generally caused by genetic mutations such as base substitutions, deletions, and insertions, which result in diverse developmental defects and remains a leading cause of birth defects. Pediatric CHD patients exhibit a spectrum of cardiac abnormalities such as septal defects, valvular defects, and abnormal chamber development. CHD onset occurs during the prenatal period and often results in early lethality during childhood. Because CRISPR-Cas9-based genome editing technology has gained considerable attention for its potential to prevent and treat diseases, we will review the CRISPR-Cas9 system as a genome editing tool and focus on its therapeutic application for CHD.

한국 최초 인공번식에 성공한 따오기의 성별구별 (Sex Identification of the First Incubated Chicks of the Crested Ibis Nipponia nippon in Korea)

  • 김경아;차재석;김태좌;김경민;박희천
    • 생명과학회지
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    • 제21권5호
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    • pp.626-630
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    • 2011
  • 세계적 멸종위기종인 따오기(Nipponia nippon)는 2008년 10월에 중국에서 1쌍이 도입된 후 한국최초로 인공번식에 성공하였다. 본 연구는 따오기의 sex-related gene과 Chromodomain Helicase DNA Binding Protein gene (CHD gene)을 가지고 polymerase chain reaction (PCR)을 수행하여 새로 태어난 따오기 유조의 성별을 확인하고자 하였다. 본 연구에서는 따오기의 성별 확인을 위해 PCR후 제한효소의 처리 방법과 P2과 P8를 이용한 PCR 방법을 실시하였을 때 더 정확한 결과가 나타남을 알 수 있었다. 그리고 CHD gene의 염기서열을 선행연구와 비교해 본 결과, 암컷의 염기서열에서 1~2 base pairs 차이가 나타남을 알 수 있었다.

The Association of Hospital Volume of Percutaneous Coronary Intervention with Cardiac Mortality

  • Kim, Jae-Hyun;Kim, Jang-Mook;Park, Eun-Cheol
    • 보건행정학회지
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    • 제28권2호
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    • pp.168-177
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    • 2018
  • Background: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. Methods: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. Results: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. Conclusion: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.

Evidence-based estimation of health care cost savings from the use of omega-3 supplementation among the elderly in Korea

  • Hwang, Ji-Yun;Kim, Wu Seon;Jeong, Sewon;Kwon, Oran
    • Nutrition Research and Practice
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    • 제9권4호
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    • pp.400-403
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    • 2015
  • BACKGROUND/OBJECTIVES: By the year 2050, thirty-eight percent of the Korean population will be over the age of 65. Health care costs for Koreans over age 65 reached 15.4 trillion Korean won in 2011, accounting for a third of the total health care costs for the population. Chronic degenerative diseases, including coronary heart disease (CHD), drive long-term health care costs at an alarming annual rate. In the elderly population, loss of independence is one of the main reasons for this increase in health care costs. Korean heath policies place a high priority on the prevention of CHD because it is a major cause of morbidity and mortality. SUBJECTS/METHODS: This evidence-based study aims to the estimate potential health care cost savings resulting from the daily intake of omega-3 fatty acid supplementation. Potential cost savings associated with a reduced risk of CHD and the medical costs potentially avoided through risk reduction, including hospitalizations and physician services, were estimated using a Congressional Budget Office cost accounting methodology. RESULTS: The estimate of the seven-year (2005-2011) net savings in medical costs resulting from a reduction in the incidence of CHD among the elderly population through the daily use of omega-3 fatty acids was approximately 210 billion Korean won. Approximately 92,997 hospitalizations due to CHD could be avoided over the seven years. CONCLUSIONS: Our findings suggest that omega-3 supplementation in older individuals may yield substantial cost-savings by reducing the risk of CHD. It should be noted that additional health and cost benefits need to be revisited and re-evaluated as more is known about possible data sources or as new data become available.

CHD4 Conceals Aberrant CTCF-Binding Sites at TAD Interiors by Regulating Chromatin Accessibility in Mouse Embryonic Stem Cells

  • Han, Sungwook;Lee, Hosuk;Lee, Andrew J.;Kim, Seung-Kyoon;Jung, Inkyung;Koh, Gou Young;Kim, Tae-Kyung;Lee, Daeyoup
    • Molecules and Cells
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    • 제44권11호
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    • pp.805-829
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    • 2021
  • CCCTC-binding factor (CTCF) critically contributes to 3D chromatin organization by determining topologically associated domain (TAD) borders. Although CTCF primarily binds at TAD borders, there also exist putative CTCF-binding sites within TADs, which are spread throughout the genome by retrotransposition. However, the detailed mechanism responsible for masking the putative CTCF-binding sites remains largely elusive. Here, we show that the ATP-dependent chromatin remodeler, chromodomain helicase DNA-binding 4 (CHD4), regulates chromatin accessibility to conceal aberrant CTCF-binding sites embedded in H3K9me3-enriched heterochromatic B2 short interspersed nuclear elements (SINEs) in mouse embryonic stem cells (mESCs). Upon CHD4 depletion, these aberrant CTCF-binding sites become accessible and aberrant CTCF recruitment occurs within TADs, resulting in disorganization of local TADs. RNA-binding intrinsically disordered domains (IDRs) of CHD4 are required to prevent this aberrant CTCF binding, and CHD4 is critical for the repression of B2 SINE transcripts. These results collectively reveal that a CHD4-mediated mechanism ensures appropriate CTCF binding and associated TAD organization in mESCs.