• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.32-37
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• 2019

Kounis syndrome is defined as the occurrence of acute coronary syndrome associated with vasoactive mediators, such as histamines in the setting of hypersensitivity and allergic reactions or anaphylactic insults. The condition can be caused by various drugs, foods, or environmental factors that cause allergic reactions. A 35-year-old male visited the emergency room with anaphylaxis accompanied by chest pain approximately 20 minutes after taking zaltoprofen, a nonsteroidal anti-inflammatory drug. After acute treatment for the anaphylaxis, the patient was stabilized and all symptoms disappeared, but the ischemic changes in the electrocardiogram and elevation of the cardiac enzymes were observed. The emergency cardiac angiography and echocardiography were all normal. The allergic reaction of this patient to zaltoprofen was believed to cause a temporary coronary arterial vasospasm, inducing Type 1 Kounis syndrome. Thus far, there have been case reports of Kounis syndrome caused by a range of nonsteroidal anti-inflammatory drugs, but there are no reports of the condition being caused by zaltoprofen. According to the pathophysiology, both cardiac and allergic symptoms must be solved simultaneously, so rapid treatment and diagnosis are needed. Doctors treating acute allergic reactions and anaphylaxis patients must check the cardiovascular symptoms thoroughly and consider the possibility of Kounis syndrome.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.433-443
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• 1997

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objective information for patients undergoing cardiac catheterization : 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms -coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor or nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%. and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.599-603
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• 2004

Primary pericardial malignant mesothelioma is a lethal and rare cardiac neoplasm of mesodermal origin. Most cases are associated with history of pericarditis with constriction and/or tamponade. Authors experienced a case of primary pericardial malignant mesothelioma in a 55-year old female who had suffered from dyspnea and chest pain. Pericardial nodules revealed intense uptake by FDG-PET scan and confirmed as primary pericardial malignant mesothelioma by thoracoscopic biopsy. Here we report this case with a brief review of the relevant literatures.

• Journal of Korean Medical classics
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• v.3
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• pp.151-217
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• 1989

In this thesis, I intend to study the translational and clinical interpretation through the theory of Ja-Yeol, and reached the following conclusions. 1. Liver-Heat-Disease due to absess of the function of expelling and lifting off, that Liver-Yang cannot lift up to upper-warmer, and stagnate liver. I think the symptoms of yellowish urine, abdominal pain, somnolence, fever belong to the syndrome of 'Gi-Bun(氣分)', and the symptoms of ravings with surprising, distending pain of hypochondrium, restless involuntary movement of the limbs, unable to lie flat belong to the syndrome of 'Hyeol-Bun(血分)'. 2. Heart-Heat-Disease due that 'Eum-Gi(陰氣)' in heart cannot lay down and reach to stagnate at heart, inner part. I think the symptoms of unjoy, acute cardiac pain, fidgetiness, well-nausea, headeche, reddish face, anhidrosis, etc. reveal with Heart-Heat-Disease. 3. Spleen-Beat-Disease due that 'Eum-Gi' in spleen cannot lay down and Yin of spleen changs heat. I think the symptoms of heaviness of head, cheek pain, fidgetiness, cyanosis, well-nausea, fever, not to let flex and reflex with back pain, diarrhea with abdominal pain, left and right cheek pain reveal with Spleen-Heat-Disease. I think symptoms of fever, diarrhea with abdominal pain belong to the syndrome of Yin-exhausion. 4. Lung-Heat-Disease due to that 'Eum-Gi' in lung cannot lay down. When 'Wi-Gi(衛氣)' stagnates at external part, I think, the symptoms of intolerance to wind and cold, yellowish fur, fever reveal. When Wi-Gi stagnates at lung, inner part, I think, the symptoms of dispnea with cough, pain on chest and back, unable to breath deeply, hydrosis and chilling reveal. 5. Kidney-Heat-Disease, in that the symptoms of back pain, leg aching, extreme thirst and frequently drink, fever, pain and stiffness of nape, cooling and aching leg, heat on plantar pedis, not trying to speak reveal is regarded external heat disease of 'Tai-Yang-Gyeong's(太陽經)' disease that asthenic fever open 'Tai-Yang-Gyeong' and lift by not enough of 'Yang-Gi(陽氣)' lifeing up from Kidney space, the water space of five elements.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.297-300
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• 2007

Idiopathic hypereosinophilic syndrome is a rare systemic, leukoproliferative disorder characterized by eosinophilmediated tissue injury causing multiple organ failure, including the heart. Cardiac involvement occurs in more than 75% of patients with hypereosinophilic syndrome. Cardiac manifestations include subendocardial fibrosis, thrombus leading to peripheral emboli, restrictive cardiomyopathy, and valvular dysfunction. It is more common in men than in women (9 : 1), and trends to present between the ages of 20 and 50 years. Presentation in childhood is unusual. We report for the first time a case of a 58-year-old man with idiopathic hypereosinophilic syndrome manifested by prosthetic aortic valve dysfunction that was successfully treated by steroid and hydroxyurea therapy after surgical valvular replacement.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.285-289
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• 2017

Pheochromocytoma can present with various symptoms including cardiogenic shock and cardiac arrest. Particularly, in cases of cardiogenic shock of unknown origin, pheochromocytoma should be considered. A 20-year-old woman without any medical history visited our emergency department due to nausea, vomiting, headache, and chest pain. Echocardiography revealed severe left ventricular dysfunction. Mechanical ventilation and veno-arterial extracorporeal membrane oxygenation (ECMO) were implemented owing to her unstable vital signs. For unstable vital sign and cardiogenic shock in a young woman without any previous medical history, pheochromocytoma was considered and diagnosed based on elevated levels of catecholamine derivatives in a 24-hour urine sample. Cardiac function recovered and ECMO was discontinued on the 5th day of hospitalization. She later underwent an elective adrenalectomy and no recurrence was found during the follow-up period. We reported a case of pheochromocytoma which was presented with cardiogenic shock in a young woman with no concomitant disease, and successfully treated with ECMO followed by an elective adrenalectomy.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.26-38
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• 2023

BACKGROUND: Dobutamine and adenosine stress cardiac magnetic resonance (CMR) imaging is relatively contraindicated in patients with moderate to severe aortic valve stenosis (AS). We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS. METHODS: In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR for exclusion of obstructive coronary artery disease were enrolled. We recorded clinical data, CMR and echocardiography findings, and complications as well as minor symptoms. Patients with AS were compared to matched individuals without AS. RESULTS: A total of 187 patients with AS were identified and compared to age-, gender- and body mass index-matched 187 patients without AS. No severe complications were reported in the study nor the control group. The reported frequency of non-severe complications and minor symptoms were similar between the study and the control groups. Nineteen patients with AS experienced non-severe complications or minor symptoms during dobutamine stress CMR compared to eighteen patients without AS (p = 0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced minor symptoms (p = 0.562). Four examinations were aborted because of chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Inducible ischaemia, prior coronary artery bypass grafting, prior stroke and age were associated with a higher incidence of complications and minor symptoms. CONCLUSIONS: Moderate to severe AS was not associated with complications during CMR stress test. The incidence of non-severe complications and minor symptoms was greater with dobutamine.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.41-45
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• 2012

Recently, some patients have visited the emergency department for treatment of different symptoms of acute poisoning after intake of unidentified herbs, which can be mistaken for wild edible greens, because wild edible greens are good for health and contain vitamins, enzymes, minerals, fibers, and anticancer materials. Winter or early spring, is extremely high, with rapid onset of severe symptoms of poisoning. There have been no reports of poisoning by SymplocarpusRenifolius in Korea, however, we report on three severe cases involving patients who experienced cardiogenic shock with nausea, vomiting, abdominal pain, chest discomfort, dizziness, numbness, and general weakness.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1150-1154
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• 1995

Pneumomediastinum[Mediastinal emphysema is characterized by the presence of air in the mediastinum, and classified as spontaneous[occurring without obvious cause or secondary[caused by a trauma or artificial ventilation . To study the clinical evaluation of pneumomediastinum, data were obtained from 20 patients. The incidences of spontaneous pneumomedisastinum were 5 and those of secondary pneumomedistinum were 15 cases. The mean age was 21.2$\pm$3.4 years[$\pm$SD in spontaneous pneumomediastinum and 44.1$\pm$20.0 years[$\pm$SD in secondary pneumomediastinum. There were 16 male and 4 female patients. The common presenting compliants were retrosternal pain in 19 patients[95% , dyspnea in 12[60% , and hoarsness in 2[10% . The predisposing factors were asthma,excessive exercise and vomiting in spontaneous pneumomediastinum;trauma, artificial ventilation, tracheostomy, the rupture of trachea or esophagus in secondary pneumomediastinum. The physical findings were subcutaneous emphysema in 17 patients[85% , Hamman`s sign in 11 patients[55% and decreased cardiac dullness in 2 patients[10% . Spontaneous pneumomediastinums were managed conservatively, however, surigical procedures were needed in secondary pneumomediastinums. There was no recurrence, but one patinet died of tension pneumomedistinum. We concluded that spontaneous pneumomediastinum is uncommon, usually benign, and self-limited and secondary pneumomedistinum due to trauma or artificial ventilation is more increasing, and necessitates the early, aggressive intervention.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.448-451
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• 2004

Report of right atrial thrombus complicating pulmonary embolism after cardiac surgery is rare. A 54-year-old woman operated on the atrial septal defect 10 months ago was admitted for left pleuritic pain and dyspnea. Multiple segmental perfusion defects were detected in lung perfusion scan. Transesophageal echocardiography showed a large mobile right atrial mass attached to the free wall of the right atrium with a stalk. Despite the intravenous heparinization for 13 days, follow-up echocardiography revealed the right atrial mass had not diminished in size. The mass which was confirmed as an organizing thrombus was excised under cardiopulmonary bypass. The patient recovered uneventfully and was discharged on warfarin therapy.