• Title/Summary/Keyword: Chest Support

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Twenty-Year Experience of Heart Transplantation: Early and Long-Term Results

  • Lee, Jae-Hong;Yeom, Sang Yoon;Hwang, Ho Young;Choi, Jae-Woong;Cho, Hyun-Jai;Lee, Hae-Young;Huh, Jae-Hak;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.242-249
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    • 2016
  • Background: We evaluated early and long-term results after heart transplantation (HTPL). Methods: One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results: Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion: Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients.

Right Heart Failure during Veno-Venous Extracorporeal Membrane Oxygenation for H1N1 Induced Acute Respiratory Distress Syndrome: Case Report and Literature Review

  • Lee, Seung-Hun;Jung, Jae-Seung;Chung, Jae-Ho;Lee, Kwang-Hyung;Kim, Hee-Jung;Son, Ho-Sung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.289-293
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    • 2015
  • A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

Veno-venous Extracorporeal Membrane Oxygenation with a Double Lumen Catheter for Pediatric Pulmonary Support (급성호흡부전 환아에게 이중관 캐뉼라로 시행한 정맥간 체외막형산화장치)

  • Choi, Min-Suk;Yang, Ji-Hyuk;Jun, Tae-Gook;Lee, Young-Tak;Ahn, Kang-Mo
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.168-171
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    • 2010
  • The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.

Study of Clinical Characterized of Acute Myocardiac Infarction Patients on Youth & Adults Age in Emergency Room (응급실로 내원한 청장년층 급성심근경색증 환자의 임상특성 연구)

  • Hong, Hae-Sook;Jang, Yu-Ryang
    • Journal of forensic and investigative science
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    • v.3 no.1
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    • pp.50-59
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    • 2008
  • The purpose of this study was to figure out clinical characteristics in young and adult acute myocardial infarction patients come to emergency room. One hundred fifty four acute myocardial infarction cases were collected and analized from January 2003 to April 2006, especially focused on below the age 50. The results of the study were summarized as follows. The results were proportion up disease occur to women disease rate as men after 50 age and acute myocardial infarction occur to spring and winter most of all. Research for this patients coronary artery condition in cardiac angiography room and coronary artery condition is left anterior descending portion was obstruction and stenosis most of all at that time in emergency room. HDL-cholesterol was not normal range of this patients. About 57.9% patients downward normal range but total cholesterol was very variant condition. Investigated chest X-ray of this patients and result in upward 75% patients was C-T ratio 50% upward condition. And it was shown result from this patients 94. 7% was obesity condition and family history showed mother or father got hypertension or diabete mellitus patients but 42. 7% patients not family history. This patients not going to direct emergency room after via local medical center result in badly condition up. Have got outcomes of youth and adults age patient of acute myocardial infarction come to emergency room. Government and administration have to support advertising this results about acute myocardial infarction condition of nation people. We need to preservation and preventing this disease but if this disease occurrence, to the utmost directly and speedly emergency room for fast therapy.

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Surgical Treatment of Traumatic Pulmonary Cyst -A case report- (외상성 폐낭종의 외과적 치료)

  • O, Seong-Cheol;Lee, Seong-Ju;Kim, Chang-Hui;Chae, Seong-Su
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.577-580
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    • 1996
  • Traumatic pulmonary cysts are rare cavitary pulmonary lesions following nonpenetrating thoracic trauma. The pathogenesis of this lesion Is a tear in the pulmonary parenchyma with leakage of air and fluid into this tear. The diagnosis is one of exclusion, based on an awareness that lung cyst can develop after trauma. Once traumatic lung cyst is diagnosed, the principle of the treatment is in-hospital obser- vation with respirato y support. However, if a cyst is complicated by infection unresponsive to a trial of appropriate antibiotic therapy and does not progressively become smaller, surgical intervention is indicated. Authors recently experienced a case of traumatic lung cyst in a 19 year-old man. Case presentation and review of articles on traumatic pulmonary cyst follows.

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Open Heart Surgery in Infants Weighing Less than 3kg (체중 3kg 이하 소아에서의 개심술)

  • 이창하
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.630-637
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    • 2000
  • Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.

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Video-Assisted Thoracoscopic Lung Volume Reduction Surgery in Severe Emphysema -A Case Report (폐기종 환자에서의 흉강내시경을 이용한 폐용적 감축술 -1례 보고-)

  • Lee, Du-Yeon;Jo, Hyeon-Min;Mun, Dong-Seok
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.827-832
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    • 1997
  • Lung volume reduction surgery(LVRS) has recently been advocated as an alternative or a bridge to lung transplantation for patients with evere dibbling emphysema. This procedure is a palliative treatment performed to alleviate the dyspnea of patients with emphysema and improve performance in the activities of daily living. The rationale of lung volume reduction for generalized emphysema is that the removing of the diseased and functionless lung may improve the function of remaining, less diseased lung. The factors critical to the success of LVRS are careful patient selection, accurate localization of target areas, meticulous anesthetic and operative technique, and intensive postoperative support. We have experienced a case of severe emphysema in a 59-year-old male patient. After selection process and pulmonary rehabilitation, the patient was treated with video-assisted thoracoscopic LVRS and the post-operative course was uneventful.

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A Case Report of Heart Transplantation Bridged by Bi-ventricular Assist Device in a Pediatric Patient of Prerenal Type ARF (소아환자에서 양심실 순환보조를 중개로 한 후 발생한 급성신부전 환자에서의 심장 이식수술 치험 1예)

  • Ra, Yong-Joon;Koak, Jae-Gun;Kim, Jin-Hyun;Oh, Se-Jin;Lee, Jae-Hang;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.854-857
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    • 2006
  • The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

A Study on School Health Promotion Services (학교보건사업을 통한 건강증진 사업에 대한 연구)

  • Nam, Chul Hyun
    • Journal of the Korean Society of School Health
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    • v.10 no.2
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    • pp.193-211
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    • 1997
  • The study was designed to gain necessary basic data in order to grasp the health knowledge, attitude, and practice level of students and teachers of elementary, middle and high schools. This study was conducted through interviews of 3,400 students and 1,022 teachers attending 14 different schools large, middle and small cities and rural towns during a period of nine months (from Oct. 2 1995 to Jun. 30 1996). By the results of this study, the recommendations can be summarized as follows: 1. A school health development committee should be established of 10 members: school health related teachers (physical trainers, nurses, and teachers in charge of health), parents, persons related to health administration, local medical doctors, and student reprensentatives in order to support and immplement school health development plans. 2. Like advanced countries, a health class of 2~4 hours should beplaced in middle and high schools. A nurse majoring in health from a university should be the teacher. 3. A curriculum of health should contain the following: education on health, sex, alcohol, tabacco, the misuse of the drugs, the structure and function of human body, the growth of the body, mental health, safety and emergency care, the prevention of disease, proper eating habits and nutrition, daily health life, family health education, society health, community health, environmental pollution and individual responsibility. 4. Create a school health promotion center, with a nurse's office, and a sports center which has health machines (bars, aerobics, training, twist machine, belt massage, running machine, bench press, chest waist, hack hip extension machine) as well as a physical strength measuring machine (muscular strength, alertness, flexibility, endurance, lung functions and so on), so that the teaching staff and students can use them and train their bodies. 5. Through a refresher education program, urge teachers to understand school health promotion services. 6. Regulate a standard and establish a system of monitoring the physical enviroment of the school (the height of desks and chairs, illumination facilities, ventilation facilities, safe drinking water). 7. Create a check list of health to evaluate improvement.

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A Study on Elderly Women's Breast Types and Their Brassiere Sizes (노년여성(老年女性)의 유방형태(乳房形態) 분석(分析)과 브래지어 착용(着用) 치수분포(値數分布) 연구(硏究))

  • Park, Sung-Yi;Sohn, Hee-Soon
    • Journal of Fashion Business
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    • v.5 no.4
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    • pp.144-157
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    • 2001
  • The purpose of this study was to research on breast shape and size to suggest a brassiere sizing chart for elderly women. For this purpose 90 elderly women aged between 55 and 69 were sampled at random to review their breast types by age group, and thereby, suggest the basic measurements and production ratio of each brassiere size in reference to KS K 0070: 1999. The collected measurement data were processed statistically using the SPSS PC/WIN program for technical statistical analysis. The results of this study can be summarized as follows; 1. Analysis of Breast Measurements To find out difference among age groups, the 90 subjects were grouped into three(Group 1 ; aged 55 to 59, Group 2 ; aged 60 to 64, Group 3 ; aged 65 to 69). The results of the comparative analysis of anthropometric data from three groups show that getting older;- Various length measurements related to the drooping degree of breast were increased. It was found that the older group in their 65-69's had more drooping breasts than their 55-59's or 60-64's counterparts. Such findings suggests that older women's drooping can be corrected by a brassiere which serves to support the breasts. 2. Suggestions on a Brassiere Sizing For the basic measurements of brassiere parts for the elderly women, the correlation between underchest circumferences and cup sizes were analyzed. 3% or higher occurrences among the whole sample elderly women were included in the brassiere sizes. thus, the under-chest measurements were set at four intervals from 75 to 95, while the cup measurements were determined also at four intervals from "AAA" to "B" sizes. The resultant 6 sizes excluding the least frequent occurrences covered 73.2% of the sample elderly women actual breast sizes. As a consequence of reviewing the production ratio of each brassiere size for the women, it was found that the brassiere size of highest production ratio was "85A" (17.4%), followed by 80A (14.5%), 85AA 90A (10.1%) and 75A (8.7%) in their order.

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