• 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.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.406-409
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• 2018

Aortocaval fistula (ACF) occurs in <1% of all abdominal aortic aneurysms (AAAs), and in 3% to 7% of all ruptured AAAs. The triad of clinical findings of AAA with ACF are abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass. Other findings include pelvic venous hypertension (hematuria, oliguria, scrotal edema), lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. Surgery is the main treatment modality. We report successful surgical treatment in a patient with a ruptured AAA with ACF who presented with cardiogenic shock.

• Research in Community and Public Health Nursing
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• v.8 no.2
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• pp.262-276
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• 1997

This study evaluates the relationship between health belief. self-efficacy and exercise and diet compliance in coronary heart disease patients. The study subjects were 96 CHD patients who visited the outpatient clinic at 3 general hospitals in Taegu city from April 3, 1997 to May 3, 1997. Data was collected by the researcher and two registered nurses who work at a cardiac outpatient clinic. Face-to-face interview was conducted. Moon's health belief scale(l990) and Hicky and others' Cardiac Diet Self-Efficacy Instrument (CDSEI, 1992), Cardiac Exercise Self-Efficacy Instrument (CESEI, 1992) were used. The instrument developed by the researcher based on the reference review was used to measure exercise and diet compliance. The data were analyzed by using descriptive statistics, Pearson correlation coefficient, t-test, ANOVA, Tukey verification and Stepwise multiple regression with the SAS program. The results of this study were as follows; 1. The degree of health belief(score range: 1-4) perceived benefit: 3.06 barrier: 2.04 severity: 2.93 2. The degree of self-efficacy(score range: 1-5) exercise self-efficacy: 2.91 diet self-efficacy: 3.32 3. The degree of compliance (score range: 1-4) exercise compliance: 2.34 diet compliance: 2.95 4. The exercise compliance had a positive correlation with perceived benefit(r=0.5327, p=0. 0001), severity(r=0.2780, p=0.0061), exercise self-efficacy(r=0.6675, p=0.0001), and a negative correlation with barrier{r= -0.4236, p=0.0001). The diet compliance had a positive correlation with perceived benefit (r=0.6439, p=0.0001), severity(r=0.4244, p=0.0001), diet self-efficacy(r=0.6629, p=0.0001), and a negative correlation with barrier{r= -0.5098, p=0.0001). 5. According to pt's education level, (F=3.02, p=0.0336), received massage from mass media on exercise and diet(t=3.81, p=0.0002), presence of cardiac patients in the family members or friends(t=2.00, p=0.0478), created significant differences in exercise compliance. According to occuption(F=3.03, p=0.0215), hospitalized experience(t=4.59, p=0.0000), presence of chest pain(t=3.63, p=0.0005), there was also a significant difference in diet compliance. 6. The combination of exercise self-efficacy, perceived benefit and pt's education level explained 50.18% of the variance in exercise compliance. The combination of diet self-efficacy, perceived benefit and barrier explained 56.76% of the variance in diet compliance. On the basis of the above findings, the follow ing recommendations are suggested: 1. To promote the exercise. diet compliance for CHD patients, a well organized health teaching and nursing intervention program should be developed. 2. More research is needed to investigate other variables affecting exercise and diet compliance of CHD patients. 3. To promote self-efficacy and a positive health belief in CHD patients, a well organized and an approachable nursing intervention program should be developed. 4. Factors other than diet. exercise compliance should be evaluated to discover the impact on CHD patients.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.363-366
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• 2003

Background: Left ventricular rupture after acute myocardial infarction is a serious complication with high mortality. Emergency operation is usually the only available treatment. A 76-year-old female with persistent chest pain and syncopal attacks was admitted. Transthoracic echocardiography showed the pericardial effusion and generalized hypokinesia of the inferolateral wall of left ventricle. Coronary angiography revealed a total occlusion of the first diagonal branch. After percutaneous transluminal coronary angioplasty with coronary stent and insertion of intraaortic balloon pump, emergency operation was performed. Under cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia, coronary artery bypass graft with saphenous vein, pericardial patch covering on the rupture area with 6-0 polypropylene running sutures, and fibrin glue compression under the patch were performed. We present a case of left ventricular (free wall) rupture after acute myocardial infarction.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.51-62
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• 2019

Objectives: This study was designed to evaluate the macrophages polarization of traditional Korean medicine on cardiac pain about Geum-Gwe-Yo-Ryak's two prescriptions including Kwaruhaebaekbanha-tang (KHB) and Kwaruhaebaekpaekju-tang (KHP). Materials and methods: Flow cytometry analysis was used to measure the changes in the ratio of M1 type and M2 type macrophages. Protein expression of nuclear factor-like 2 (Nrf2), heme oxygenase-1 (HO-1), inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) were measured by Western Blot, and ABCA1 and SR-B1 were detected by real time PCR (RT-PCR). Intracellular lipid accumulation was measured by Oil Red O staining (ORO staining). Results: KHB and KHP increase anti-oxidative activity related protein levels including Nrf2 and HO-1. Furthermore, KHB and KHP inhibit lipid accumulation on intracellular levels through induction of ATP binding receptor cassette subfamily A member 1 (ABCA1) and scavenging receptor class B member 1 (SR-B1), respectively. Finally, KHB and KHP also blocked pro-inflammatory mediators including tumor necrosis factor-alpha ($TNF{\alpha}$) and interleukin-6 (IL-6), iNOS and COX-2 expression. Conclusion: This study suggests that KHB and KHP potently regulate the M1/M2 macrophage polarization.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.100-103
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• 2010

We report her on a rare case of a renal stent that migrated into the right ventricle in a patient with nutcracker syndrome. A 29-year-old woman was admitted to the hospital and she was suffering from flank pain. The computed tomography of the abdomen demonstrated that the left renal vein was compressed between the abdominal aorta and the superior mesenteric artery (nutcracker syndrome). A self expandable stent was placed across the left renal vein for treating her nutcracker syndrome. The next day after the procedure, the follow up chest radiograph showed that the displaced stent had migrated into the right ventricle. After percutanous endovascular stent removal had failed, the stent was ultimately removed by performing cardiac surgery. At the $6^{th}$ postoperative month, there have been no abdominal or cardiac symptoms.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.100-107
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• 2003

Purpose : To assess the usefulness of cardiac MR imaging (MRI) in the diagnosis of acute myocardial infarction and in the assessment of myocardial viability in comparision with T1-201 SPECT. Materials and Methods : We retrospectively studied 17 patients who complained of chest pain and dyspnea with cardiac MRI . The patients were evaluated for the presence or absence of high signal intensity on T2-weighted image (T2wI), abnormal wall motion on 2D-FIESTA, perfusion defect on Gd-DTPA enhanced T1WI, and delayed myocardial enhancement on 15-minutes delay Gd-DTPA enhanced T1WI. The results were correlated with the images on T1-201 SPECT, taken at rest and stress, through which reversibility of perfusion defect was assessed. Results : Both cardiac MRI and T1-201 SPECT proved to be useful methods for diagnosing acute myocardial infarction. In order of decreasing correspondence, T2WI, T1-201 SPECT, delayed enhancement study, and wall motion images all showed significant statistical correlation with the clinical diagnosis of myocardial infarction. Perfusion MRI, on the other hand, showed no significant statistical difference was found between T1-201 SPECT and cardiac MRI. The results on T2WI showed high accordance with those on Tl-201 SPECT, while delayed myocardial enhancement and wall motion studies showed no agreement with Tl-201 SPECT. Conclusion : Cardiac MRI is useful method for diagnosis of acute myocardiac infarction. With respect to the assessment of myocardial viability, the results obtained on cardiac MRI showed high agreement with those on Tl-201 SPECT. However, further study is necessary at this point for standardization and establishment of the methods for assessing myocardial viability on cardiac MRI.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.288-291
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• 2007

Background: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment, Material and Method: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. Result: The mean age of the patients was $53.5{\pm}14.0$ years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases, The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: $84.0{\pm}71.3$ months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. Conclusion: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.413-416
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• 2010

A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.