• Title/Summary/Keyword: Chest Pain

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The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation

  • Ahn, Chi Bum;Kang, Yang Jun;Kim, Myoung Gon;Yang, Sung;Lim, Choon Hak;Son, Ho Sung;Kim, Ji Sung;Lee, So Young;Son, Kuk Hui;Sun, Kyung
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.145-150
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    • 2016
  • Background: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous $O_2$ saturation, and lactate were measured. Results: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

Hybrid Endovascular Repair for Type I Endoleak after Stent Grafting of Chronic Stanford Type B Aortic Dissection (만성 Stanford B형 대동맥 박리로 하행 대동맥 스텐트 도관 삽입술 후 발생한 제I형 Endoleak의 치료에 시행한 Hybrid 혈관내 술식)

  • Kim, Kwan-Wook;Cho, Sang-Ho;Shim, Won-Heum;Youn, Young-Nam
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.428-432
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    • 2010
  • A 67 years old male patient was admitted with back pain that had recurred from 6 months previously. Eleven years previously, he underwent stent grafting at the descending thoracic aorta for a chronic Stanford type B aortic dissection. The preoperative computed tomography showed aortic dissection from the origin of the left subclavian artery to the bifurcation of the abdominal aorta, and there was a type I endoleak at the proximal portion of the stent graft and aneurysmal dilatation of the descending aorta. A hybrid endovascular repair was successfully performed, and this involved debranching and rerouting the aortic arch vessels under extracorporeal cardiopulmonary bypass and then this was followed 13 days later by stenting in the ascending aorta, the aortic arch and the descending aorta. The postoperative computed tomography showed complete exclusion of the type I endoleak. After discharge, he has been followed up for 8 months without any problems.

The Role of Bone Scans in Routine Preoperative Evaluations of Non-Small Cell Lung Cancer Patients. (비소세포 폐암의 병기에 있어 통상적인 골 스캔의 역할)

  • 김영태;홍장미;이재익;이정상;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.659-663
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    • 2002
  • The objective of this study was to assess the usefulness of bone scans in routine preoperative examinations of patients with newly diagnosed non-small cell lung carcinoma. Material and Method: We reviewed the medical records of 258 patients who were newly diagnosed with non-small cell lung cancer in our hospital between January 2000 and December 2000. More than half of the patients (132) were deemed to be inoperable due to their advanced stage based on the CT scans. The remaining 126 patients were considered potentially operable. For these patients, clinical evaluation including the presence of bone pain, serum alkaline phosphatase, and calcium levels was used as clinical predictors of bone metastasis. All patients received bone scans. Bone X-rays, MRI or bone biopsy were performed to confirm the presence of bone metastasis. The usefulness of the bone scan was evaluated by comparing its power of predicting bone metastasis to that of the clinical information. Result: In all patients, the positive and negative predictive values of bone scans for the bone metastasis were 44%, and 99%, respectively. Those of the clinical information were 38% , and 94%. However, in potentially operable patients, the negative predictive value of the clinical information was as high as 99%. Conclusion: If newly diagnosed non-small cell lung cancer patients are presented as potentially operable on the basis of CT scan with no clinical evidence of distant metastases, curative resection could be considered without performing routine bone scans because of the low probability of bone metastasis. However, if there are positive clinical findings, further evaluations, including bone scan should be followed as metastasis will be documented in more than 30% of patients.

A Case of Cholethorax following Percutaneous Transhepatic Cholangioscopy (경피경간 담도내시경술 이후에 발병한 담즙흉 1예)

  • Park, Chan Sung;Lee, Soon Jung;Do, Gi Won;Oh, Ssang Yong;Cho, Hyun;Kim, Min Su;Hong, Il Ki;Bang, Sung Jo;Jegal, Yang Jin;Ahn, Jong-Joon;Seo, Kwang Won
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.131-136
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    • 2008
  • Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

A Case of Extensive Stage Small Cell Lung Cancer Presenting as an Acute Appendicitis with Perforation (전이성 병소에 의해 발생한 급성 충수염의 천공으로 진단된 전신병기 소세포폐암 1예)

  • Shin, Dong Won;Choi, Moon Han;Park, Seung Sik;Park, Sung Woo;Kim, Ki Up;Jang, An Soo;Park, Choon-Sik;Lim, Cheol Wan;Ko, Eun Suk;Paik, Sang Hyun;Kim, Do Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.230-234
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    • 2008
  • The incidence of appendiceal metastatic cancer is quite low. In particular, in small cell lung cancer, there is a very low incidence of a metastasis to the appendix. A 75-years old man with right lower quadrant pain, cough and sputum was transferred to our hospital. Abdominal CT revealed acute appendicitis with a perforation. The patient underwent surgery. The frozen sections of the tissue obtained during surgery, indicated a malignancy, but a right hemicolectomy was not performed due to the patient's poor general condition. The histology findings of the appendix were identified as a small cell carcinoma. The abdominal CT scan and chest x-ray at admission day showed a mass in the right lower lobe, and a further evaluation of the lesion was performed including positron emission tomography and flexible bronchoscopy with a biopsy. The pathology findings of the lung mass were also small cell lung cancer. The specimens from both sites stained positive for cytokeratin, cluster designation 56, synaptophysin, chromogranin-A and thyroid transcription factor 1. It was concluded that the appendiceal small cell cancer originated from the lung.

The Relationship between Health Belief.Self-efficacy and Exercise.Diet Compliance in Coronary Heart Disease Patients (관상동맥질환자의 건강신념 및 자기효능감과 운동 및 식이요법 이행과의 관계)

  • Nam, Myung-Hee;Kim, Chung-Nam;Oh, Yun-Jung
    • 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.

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Studies on the Similar Effects between Jwahun(坐薰) and Sojucheon(小周天)_Practice (좌훈(坐薰)과 소주천(小周天) 수련의 상관성에 관한 연구)

  • Huh, Ji-In;Lee, Jae-Heung;Choi, Hyeong-Il;Lee, Gye-Seung
    • Journal of Korean Medical Ki-Gong Academy
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    • v.11 no.1
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    • pp.144-172
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    • 2009
  • objectives : This research aimed to study the similar effects between Jwahun and Sojucheon_practice, as both Induces to SooSengg-HwaGang(the coordination of water and fire). methods : 141 recipients of the survey was conducted in the Jwahun room of Korean medicine Hospital, which contained to body reaction between the moment of the Jwahun and after the Jwahun. And the result of them compared with the body's response of Sojucheon_practice results : 1. In a survey, 78% of the patients had responses that were sweating. The area sweating a lot in the survey is the face, abdomen, chest and was, in this order, the ratio was high. About feeling of warmth and coolness, survey of those who felt the warmth ratio was 79%, those who did not feel the coolness ratio was 77%, most of the responses were warm bodies. 46% of patients replied that feels warm in the belly. It said the fact that Jwahun directly to the lower body is to warm. 2. Symptoms of congestion of the head on the survey, 78% of investigators did not appeal. Other investigators were responding they were dizzy. Research on pain and itching, but no response was at 84%. Among the responses to the itchiness, itching perineum was 11% of the respondents. The rest was weak. 3. Associated with defecation in the survey, the investigators found that 33% of respondents said fart. Urine is 22% of respondents said. Abdominal reactions, 33% of respondents answered was taking a tone in the abdomen. In response to the whole body reaction, the most relaxing 39% of the respondents said, 22% of respondents replied that the body feel lighter. 4. After Jwahun, belly is warm and cathartic reactions were the most responsive. This said that Jwahun even after, in the lower abdomen lasting warmth as can be seen. Smooth bowel movements disproves the abdominal organs is a good move. It will also be seen in the same context of bowel movements, abdominal response when just doing Jwahun. conclusions : Jwahun activate the meridians and through the perineum stimulation induced imdokmaek(任督脈) SooSengg-HwaGang(水升火降) to enable the training and some Sojucheon can have similar effects.

Comparison of OK-432 and Doxycycline Pleurodesis for Malignant Pleural Effusions Caused by Lung Cancer (폐암에 의한 악성 흉막삼출환자에서 OK-432와 Doxycycline 흉막유착술의 비교)

  • Chung, Jae-Ho;Park, Moo-Suk;Cheong, Jae-Hee;Kim, Young-Sam;Chang, Joon;Kim, Joo-Hang;Kwak, Seung-Min;Kim, Sung-Kyu;Kim, Se-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.590-596
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    • 2002
  • Background : Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleureal effusions. Materials and Methods : 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan.1994 and Aug. 2001, were retrospectively reviewed. Response 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. Results : The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). Conclusion : with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.

The Characteristics of Hwa-byung Patients Based on Hwa-byung Epidemiologic Data (화병역학연구 자료를 기반으로 한 화병 환자의 특성)

  • Kim, Jong-Woo;Chung, Sun-Yong;Suh, Hyun-Uk;Jung, In-Chul;Lee, Seung-Gi;Kim, Bo-Kyoung;Kim, Geun-Woo;Lee, Jae-Hyuk;Kim, Lak-Hyung;Kim, Tae-Heon;Kang, Hyung-Won;Kim, Se-Hyun
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.2
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    • pp.157-169
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    • 2010
  • Objectives : The aim of this study was to investigate the characteristics of Hwa-Byung(HB) patients, draw the clinical key issue of HB, and provide the data as the basis for development of Clinical Guideline of HB. Methods : The study participants included 151 subjects who thought they have HB in 9 site. For all patients, we used HB epidemiologic study protocol, which include the Korean version of the Structured Clinical Interview for the DSM-IV Diagnosis (SCID-1), diagnostic criteria of HB, symptoms check list, pattern identification tool, psychiastric psychological questionaires, and Framingham coronary risk score(FRS). Results : 1. For all participants, 62 % of subjects were diagnosed with HB. These patients had comorbid DSM-IV diagnoses with depression (65%) and anxiety (27%). But 22% of these patients had only HB. 2. HB patients had various physical symptoms when visiting, were diagnosed as various disease, and undergone medical treatments in the past. Among the diagonsed illness, Gastronitestinal diseases (51.6%), psychiatric disorders(40.9%), endocrine diseases(39.8%) were being the most frequent. The frequent physical symptoms of HB patients reported were chest discomfort, head ache, pallpitation, frequent sigh, amnesia, shoulder pain, dry mouth, eye fatigue etc. 3. HB patients had high scores in psychologic questionares, CES-D, STAI, and STAXI. It means that HB patients might be low-level emotional stability. 4. Participant had negative opinion about the treatment of HB that it would be difficult or impossible (65.7%), but they neglect the need of medical treatment. Conclusions : This result shows that HB is comorbid with various psychiatric disease, but it has different physio-psychological symptoms from others and there were only HB patients. so we identify HB is independent disease. Moreover, there were the wrong perception of HB which blocking treatments. These problems support that the neccesity of development of Clinical Guideline of HB.

An Epidemiologic Study on an Outbreak of Dermatosis Associated with Moths at a Factory (독나방에 의한 피부질환의 집단 발생에 관한 역학 조사)

  • Lim, Hyun-Sul;Jung, Cheol;Kim, Doo-Hie;Sung, Yeol-Oh;Kim, Jung-Ran;Shin, Yoo-Hang
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.359-370
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    • 1996
  • An outbreak of dermatosis occurred at a machine manufacture factory in Kyongju on Aug 1995. Authors conducted a questionnaire ,survey among 92 workers in the factory and a dermatologist examined their skin lesions. Authors also collected moths and identified them. The results are as follows; 1. Forty-two cases of dermatosis were identified with attack rate of 45.7%. Attack rate was not different by company, age, sex, educational level and duration of employment. Attack rate was 47.8% among productive workers, 25.0% among clerical workers and 100.0 % among patrolmen. 2. Two cases among 42 dermatosis cases and three subjects among 50 non-cases had a history of same dermatosis last year. Four of dermatosis cases had a history of dermatosis among their family members. 3. Skin lesions of the cases were scattered or grouped rice-sized erythematous papules or vesicles. Duration of dermatosis from the onset to the time of survey was from one day to more than 30 days. The most frequent site of skin lesion was the arms(81.0 %), and it was also observed at the neck(47.6 %), abdomen(45.2 %), chest(42.9 %), legs(38.1 %) and back(35.7 %). Skin lesion was aggravated with sweating(31.0 %), after shower(16.7 %) and with scratching(11.9 %). 4. Moths were collected and identified as Euproctis subflava (Bremer). Many poisonous stings were observed on their wngs which is harmful to human. 5. Contact with moths' wing droppings to two authors on thier forearms for provocation resulted in severe immediate pain followed by prolonged pruritus. Erythematous macules quickly appeared and succeeded by firm wheal-like red papules. Authors thought that the outbreak of dermatosis was brought about by Euproctis subflava (Bremer). Further studies on the factors contributing to the prosperity of the moths in this area are needed.

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