• Journal of Chest Surgery
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• 제39권1호
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• pp.64-67
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• 2006

제1 대각지 단독 폐쇄에 의한 승모판막 전방 유두근의 파열은 매우 드물다. 66세 여자환자가 심근경색에 이은 심인성쇼크로 전원되었는데, 심초음파 및 관상동맥 조영술 결과 제1 대각지의 완전폐쇄와 승모판막 전방 유두근 파열 및 심한 승모판막 폐쇄부전증이 발견되어 응급 승모판막치환술 및 관상동맥 우회술 후 특별한 문제없이 회복하였다.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.192-195
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• 2014

The perforation of a cardiac chamber by a fractured rib after blunt trauma is a rare event. Here, we report the case of patient who was referred for multiple rib fractures after a fall from a height. The patient was found to have a penetrating cardiac injury which was detected on a computed tomography chest scan. Computed tomography is a useful screening tool for victims of blunt chest trauma. Once cardiac perforation has been confirmed or is highly suspected, it is important to preserve the patient's vital signs until reaching the operating room by minimally manuplating the chest wall and permitting hypotension, which also prevents exsanguinating hemorrhage. For the same reasons, early cardiac tamponade may also improve the patient's survival.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.172-174
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• 2005

Trauma of the vascular structure is not poplular event. In obstructive atherosclerotic vascular disease, we sometimes have needed bypass surgery. The long length subcutaneous prosthetic vascular graft are vulnerable to injury. But prosthetic vessel rupture after trauma has been rare report. A 68-year-old man was referred to Department of Emergency of the Gyeongsang National University Hospital. After he had had a blunt trauma, he found a newly appearing pulsating mass of 10 cm diameter on his right chest wall. The lesion had a turbulent blood flow in the cavity of the mass by ultrasonographic finding. The lesion was a rupture of superficial prosthetic vascular graft under the skin.

• 대한임상독성학회지
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• 제14권2호
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• pp.100-106
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• 2016

Purpose: Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system. Methods: A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled. Results: Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis. Conclusion: Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

• Journal of Chest Surgery
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• 제37권9호
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• pp.809-812
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• 2004

흉벽에 발생하는 전이성 악성 종양은 드문 질환이며 주위 장기로부터 전이되는 경우가 대부분으로 유방, 폐, 흉막, 그리고 종격동 등으로부터 주로 전이되는 것으로 알려져 있다. 특히 흉부가 아닌 먼장기로부터 전이되는 경우는 더욱 드문 것으로 알려져 있고 원발성 악성 종양이 없이 흉벽 전이에 의해 발현되는 예는 몇몇의 보고만이 있을 뿐이다. 환자는 51세 남자로 전흉벽 좌상부에 촉지되는 종괴로 절제 수술을 시행 후 전이성 간세포암종으로 진단 받았고 당시 검사상 간에 원발성 간세포암종의 증거는 없는 상태였다. 이에 원발성 종양의 증거 없이 간세포암이 흉벽으로 전이된 예를 치험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제44권2호
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• pp.178-182
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• 2011

Background: We analyzed the results of surgical reduction and fixation of ribs under thoracic epidural anesthesia and analgesia (TEA) in patients who had no more than 3 consecutive rib fractures with severe displacement to examine the clinical usefulness of this method. Materials and Methods: From May 2008 to March 2010, 35 patients underwent surgical reduction and fixation of ribs under TEA. We reviewed the indications for this technique, number of fixed ribs, combined surgical procedures for thoracic trauma, intraoperative cardiopulmonary events, postoperative complications, reestablishment of enteral nutrition, and ambulation. Results: The indications of TEA were malunion or nonunion of fractured ribs in 29 (82.9%; first operation) and incompletely ribs under previous general anesthesia in 6 (17.1%; second operation). The average number of fixed ribs per patient was 1.7 (range: 1~3). As a combined operation for thoracic trauma, 17 patients (48.6%) underwent removal of intrathoracic hematomas, and we performed repair of lung parenchyma (2), wedge resection of lung (1) for accompanying lung injury and pericardiostomy (1) for delayed hemopericardium. No patient had any intraoperative cardiopulmonary event nor did any need to switch to general anesthesia. We experienced 3 postoperative complications (8.6%): 2 extrapleural hematomas that spontaneously resolved without treatment and 1 wound infection treated with secondary closure of the wound. All patients reestablished oral feeding immediately after awakening and resumed walking ambulation the day after operation. Conclusion: Thoracic epidural anesthesia and analgesia (TEA) may positively affect cardiopulmonary function in the perioperative period. Moreover, this technique leads to an earlier return of gastrointestinal function and early ambulation without severe postoperative complications, resulting in a shortened hospital stay and lowered costs.

• Journal of Cardiovascular Imaging
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• 제31권2호
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• pp.85-95
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• 2023

BACKGROUND: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes. METHODS: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope. RESULTS: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes. CONCLUSIONS: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.

• 대한본초학회지
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• 제23권2호
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• pp.169-178
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• 2008

Objectives : Inflammation is important event in the development of vascular diseases including hypertension, atherosclerosis, and restenosis. Injinho-tang(IJHT) has been used as a traditional Korean herbal medicine since ancient times, and today it is widely used as a medication for jaundice associated with inflammation of the liver. The aim of this study was to determine whether IJHT and its components inhibit production of nitrite, an index of NO, and proinflammatory cytokines in lipopolysaccharide (LPS)-treated RAW 264.7 macrophages. Methods : Cytotoxic activity of IJHT and its components on RAW 264.7 cells was using 5-(3-caroboxymeth-oxyphenyl)-2H-tetra-zolium inner salt (MTS) assay. The nitric oxide (NO) production was measured by Griess reagent system. And proinflammatory cytokines were measured by ELISA kit. The levels of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expression were detected by western blot. Results : IJHT and its components significantly inhibited the LPS-induced NO production and iNOS expression accompanied by an attenuation of tumor necrosis factor-alpha (TNF-${\alpha}$), interleukin-6 (1L-6), IL-$1{\beta}$ and monocyte chemoattractant protein-1 (MCP-1) formation in macrophages. Conclusions : IJHT and its components inhibit LPS-induced inflammation via decreasing cytokines production. These results indicate that IJHT and its components have potential as an anti-inflammation and anti-artherosclerosis agent.

• Journal of Chest Surgery
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• 제21권5호
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• pp.935-940
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• 1988

Perforated esophagus is a surgical emergency; it is the most serious and frequently the most rapidly lethal perforation of the gastrointestinal tract. Contamination of the mediastinum and often a pleural cavity with corrosive fluids, food material and bacteria leads to cardiorespiratory embarrassment, shock, major fluid losses and fulminating infection. Despite the improved diagnostic and treatment modalities, a perforation or leak from the esophagus remains a major source of morbidity and mortality. When esophageal perforation occurs, a successful outcome can be expected only when it is diagnosed soon after the event and repaired early. Esophageal perforations have a poor prognosis after delayed surgical treatment. With the use of the Thai onlay gastric patch method, a case of postemetic spontaneous perforation of the esophagus was successfully managed 6days after the event.

• 한국시뮬레이션학회논문지
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• 제13권4호
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• pp.1-16
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• 2004

The modelling and simulation of the activation process for the heart system is meaningful to understand special excitatory and conductive system in the heart and to study cardiac functions because the heart activation conducts through this system. This thesis proposes two dimensional cellular automaton(CA) model for the activation process of the myocardium and conducted simulation by means of discrete time and discrete event algorithm. In the model, cells are classified into anatomically similar characteristic parts of the heart and each of cells has a set of cells with preassigned properties. Each cell in this model has state variables to represent the state of the cell and has some state transition rules to change values of state variables executed by state transition function. The state transition rule is simple as follows. First, the myocardium cell at rest stay in passive state. Second, if any one of neighborhood cell in the myocardium cell is active state then the state is change from passive to active state. Third, if cell's state is an active then automatically go to the refractory state after activation phase. Four, if cell's state is refractory then automatically go to the passive state after refractory phase. These state transition is processed repeatedly in all cells through the termination of simulation.