• Journal of Chest Surgery
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• 제40권10호
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• pp.719-721
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• 2007

심낭 결손증은 드문 선천성 기형으로 대부분의 경우 증상이 없이 우연히 발견되지만, 심장의 일부가 탈장되어 흉통 등의 증상을 나타내는 경우도 있다. 본 증례는 14세 여자 환자가 내원 3개월 전부터 발생한 운동 시 호흡곤란과 가슴 통증을 주소로 내원하여 부분 심낭 결손을 통한 좌심방 부속지의 탈장(herniation)이 진단되어 수술적 치료를 시행하여 보고하는 바이다.

• Journal of Chest Surgery
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• 제11권4호
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• pp.501-515
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• 1978

The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

• The Korean Journal of Pain
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• 제29권4호
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• pp.262-265
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• 2016

Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology.

• Journal of Chest Surgery
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• 제47권1호
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• pp.32-34
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• 2014

Anomalous aortic origin of the left subclavian artery (LSCA) from the left pulmonary artery (LPA) is a rare congenital cardiac malformation. We describe a case of LSCA from the LPA via ductus arteriosus in association with a double-outlet right ventricle, which never has been reported previously in Korea.

• 혜화의학회지
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• 제10권2호
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• pp.91-96
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• 2002

We arrived at the following conclusions after we have studied esophagitis through the literatures of oriental and western medicine. 1. The western medical causes of acute esophagitis are corrosiveness chemical material, esophageal or gastric disease, trauma, blister stomatitis, filamentous fungus infection and uremia of chronic patient etc, and the oriental medical causes are qi and blood stagnation, blood stasis and stagnation, stagnant phlegm by coldness, heating, dyspepsia and food poisoning etc. 2. The western medical causes of chronic esophagitis are malfunction of lower esophageal sphincter, esophageal tom chink and hernia, increase of gastric pressure by overeating, fatness, pregnancy and ascites etc, and the oriental medical causes are asthenic cardiac qi, hepatic qi attacking stomach by seven kinds of depression, cold-damp stagnation and insufficiency of gastric qi by overeating, excessive drinking and sexual indulgence etc. 3. The main symptoms of acute esophagitis are severe chest pain, instantly vomiting, swallowing pain etc, and chronic esophagitis are occasionally light chest pain, heart bum, anorexia, dysphagia, dizziness, general body weakness etc. These symptoms are come under thoracic obstruction, acid regurgitation, vomiting and chest pain of oriental medicine. 4. The western medical diagnoses of acute and chronic esophagitis have used radiation test, esophageal endoscopy, esophageal pressure test and biopsy etc, and the oriental medical diagnoses have used syndrome differentiation by four examination of inspection, listening and smelling examination, inquiring, pulse-taking and palpitation. 5. The western medical treatments of acute esophagitis have regarded preservation stability of esophagus as a principle, and the oriental medical treatments mainly have used expelling pathogen of expelling cold and regulating qi, cooling and removing stasis, promoting blood circulation to remove blood stasis, eliminating phlegm and regulating qi. 6. The western medical treatments of chronic esophagitis have regarded decrease flowing backward of gastric juice as a purpose, and the oriental medical treatments mainly have used strengthening body resistance of replenishing and strengthening cardioqi, dispersing stagnated hepatoqi, expelling cold and dehygrosis, invigorating stomach and nourishing qi.

• 대한임상독성학회지
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• 제16권2호
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• pp.176-180
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• 2018

Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

• Journal of Chest Surgery
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• 제44권5호
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• pp.377-379
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• 2011

Chylopericardium is a rare disease entity characterized by the accumulation of chylous fluid in the pericardial sac. It usually arises from mediastinal neoplasms, thrombosis of the subclavian vein, tuberculosis, nonsurgical trauma, thoracic or cardiac surgery. The spectrum of symptoms for chylopericardium varies from an incidental finding of cardiomegaly to dyspnea, upper abdominal discomfort, cough, chest pain, palpitation, fatigue. However, most of the patients are asymptomatic. The main purpose of treatment of chylopericardium is the prevention of cardiac tamponade and prevention of metabolic, nutritional, and immunological compromise due to chyle leak. Here, we report a case of chylopercardium secondary to lymphangiomyoma with review of the literature.

• Journal of Chest Surgery
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• 제12권4호
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• pp.350-354
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• 1979

The incidence of congenital aortic valvular stenosis has been known rare, and approximately 3-6% of congenital heart diseases. Recently, we experienced 1 case of congenital aortic valvular stenosis, and which was corrected surgically under extracorporeal circulation successfully. A 11 years old male pt. was admitted to N.M.C. because of dyspnea, dizziness, chest pain and episode of syncope. An auscultation, harsh systolic murmur [Gr. IV/VI] was noted at aortic area and also palpable strong thrill. ECG showed LVH c strain pattern and suspicious LVH finding in simple chest P-A film. In Lt. cardiac catheterization, abrupt pressure change [110mmHg] between LV & Aorta was noted across the aortic valve. And aortic insufficiency was absent, well visualized both coronary arteries and suspicious bicuspid aortic valve in aortography. Valve form was bicuspid, large one was noncoronary cusp and another cusp was Rt. & Lt. coronary cusp which was interpositioned rudimentary commissure. Central aortic orifice was about 5ram in diameter. Valvulotomy was done along the fusioned commissure between noncoronary cusp and Rt. & Lt.coronary cusp, and then short incision was added between Rt. coronary cusp & Lt. coronary cusp. Immediate postoperative course smooth but unknown cardiac arrest was noted in POD second day. Complete recovery was done without sequelae by resuscitation. After operation, clinical symptoms were subsided but systolic murmur [Gr. II/VI] was audible at aortic area, diastolic murmur was absent. ECG showed still remained LVH but much decreased R wave voltage in Lt. precordial leads. Simple chest P-A showed no interval changes compared to preop film. Control Lt. heart catheterization revealed still remained pressure gradient [40ramrig] between LV & Aorta. But much decreased pressure gradient compared to preop pressure gradient [110mmHg].

• Clinical and Experimental Pediatrics
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• 제58권1호
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• pp.37-40
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• 2015

The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular followup.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.264-271
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• 2018

Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.