• 제목/요약/키워드: Chronic heart failure

검색결과 120건 처리시간 0.022초

대동맥판막질환의 임상적 고찰 -판막병리 및 임상성적에 대하여- (Isolated aortic valvular heart disease : analysis of etiology and surgical experience)

  • 이승구
    • Journal of Chest Surgery
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    • 제20권2호
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    • pp.300-308
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    • 1987
  • Clinical and pathologic data were reviewed in 20 patients who had have surgery for isolated aortic valvular heart disease between April 1978 and April, 1987. Hospital mortality was 10%, with no additional late mortality during a mean follow-up period of 24.1 months. Prosthetic valve failure developed in 3 patients and two had reoperation. Niety four percent of the survivors who were in NYHA Funtional class III or IV before operation are now in class I or II. Ninety percent of all patients are still alive at a maximum follow up of 9 years. The clinical histories, gross and histologic examination of valves estabilished the causes for isolated aortic valve disease: 3 rheumatic, 2 congenital bicuspid, 2 hypertention, 2 aortitis and each one case of floppy valve, medial cystic necrosis of aorta, bacterial endocarditis. But etiology was unknown in 8 cases. Sixteen patietns had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucosaccharides and cystic changes. Myxoid degeneration was also the primary pathologic abnormality in the patients with 2 hypertention, 2 rheumatic, 1 aortitis, 1 bacterial endocarditis, 1 floppy valve, 1 congenital bicuspid. The patients with myxoid degeneration of uncertain origin were 8. Histologic finding of all of them revealed nonspecific patients with myxoid degeneration of uncertain orgin were 8. Histologic finding of all of them revealed nonspecific chronic valvulitis with myxoid degeneration. This finding may indicate that the etiology w uld be infectious.

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Evaluation of Serum Symmetric Dimethylarginine Concentrations in Dogs with Chronic Mitral Valve Insufficiency

  • Kim, Nam-Kyun;Song, Joong-Hyun;Yu, Do-Hyeon;Hwang, Tae-Sung;Lee, Hee-Chun;Jung, Dong-In
    • 한국임상수의학회지
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    • 제34권5호
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    • pp.313-317
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    • 2017
  • Symmetric dimethylarginine (SDMA) is a new renal biomarker for kidney function. It is almost exclusively eliminated by renal filtration. The purpose of this retrospective study was to evaluate the changes in serum ceatinine (CREA), blood urea nitrogen (BUN) and SDMA concentrations in dogs with chronic mitral valve insufficiency (CMVI), according to the severity of CMVI. The evaluation of the severity of CMVI was performed according to the American College of Veterinary Internal Medicine (ACVIM) classification of heart failure. The dogs were classified into two groups: group 1 (ACVIM B; n = 11) and group 2 (ACVIM C; n = 15). In dogs with advanced CMVI, the serum SDMA concentrations were significantly increased above the normal reference range and were independent of body weight (BW), systolic blood pressure (SBP), or sex. No dog in either group had higher serum CREA concentrations than the upper limit. The serum SDMA concentration may be a better renal marker than serum CREA concentrations for the early diagnoses of renal dysfunction in dogs with CMVI.

중증 폐동맥고혈압이 동반된 만성폐쇄성폐질환 1 예 (Chronic Obstructive Pulmonary Disease with Severe Pulmonary Hypertension - A Case Report -)

  • 박찬서;진현정;김석민;손창우;유성근;정진홍;이관호
    • Journal of Yeungnam Medical Science
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    • 제25권1호
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    • pp.50-57
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    • 2008
  • Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

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잡종 개에서 이첨판 폐쇄 부전증이 합병된 난원공 개존증 (Patent Foramen Ovale Complicated with Chronic Mitral Valvular Insufficiency in A Mixed Dog)

  • 이동국;한숙희;현창백
    • 한국임상수의학회지
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    • 제30권6호
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    • pp.468-472
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    • 2013
  • 12연령의 암컷 잡종개 (체중 6.2 kg)가 심한 복부 팽만, 지속적 기침 그리고 운동 불내성을 주증으로 진료 의뢰 되었다. 진단상에 복수, 경정맥 노장, 심한 좌우 심첨부 수축기 잡음 (4/6 단계), 후대정맥 확장을 동반한 전반적 심비대와 좌심방 확장이 관찰되었다. 심장 초음파에서는 퇴행성 이첨판막 그리고 삼첨판막 심내막증과 양심실성 울혈성 심부전이 관찰되었다. 좌우단락의 난원공 개존증 또한 있었다. 좌심실 수축능은 용적 과부하의 정도와 관계되어 떨어져 있었다. 진단적 결과에 기초하여, 본 증례는 ISACHC IIIa 심부전의 이첨판막과 삼첨판막 심내막증이 합병된 난원공 개존증으로 진단되었다. 이 개는 푸로세마이드 (2 mg/kg, q12hr, PO), 피모벤단 (0.3 mg/kg, q12hr, PO)와 스피로노락톤 (1 mg/kg, q12hr)으로 치료되었다. 임상 증상들은 약물 치료 후에 점차적으로 개선되었다.

림프관평활근종증에 의한 호흡부전 환자에서의 순차적양측 폐이식 치험 (Bilateral Sequential Lung Transplantation for a case with Respiratory Failure due to Lymphagioleiomyomatosis)

  • 성숙환;김주현;김영태;서정욱;유철규;김영환;한성구;심영수;오용석
    • Journal of Chest Surgery
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    • 제33권1호
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    • pp.88-95
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    • 2000
  • Pulmonary lymphangioleiomyomatosis is a chronic destruct8ive disease of the lung affecting women of childbearing ages which eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic measure because this disease responds poorly to other therapies, To date only a few reports in the literature describes the clinical experience of the bilateral sequential lung transplantation of this rare condition. We performed a bilateral sequential lung transplantation on a 32-year-old woman suffering from lymphangioleiomyo-matosisw. The heart-lung block was harvested from a 51-year-old donor. We transplanted the left lung first through the clam-shell incision. As the hemodynamics deteriorated suddenly during the dissection of the right lung the right lung was transplanted under the cardio-pulmonary bypass. Although the patient's lung function was initially satisfactory the patient died of sepsis and subsequent cardiogenic shock at the postoperative 18th day. Autopsy findings showed infection of Candida albicans on the pericardium and the left lung which had been initiated possibly from the left bronchial anastomosis site,. Through detailed review of the clinical course we concluded that lung transplantation could have been performed safely on this disease provided that early diagnosis and proper management or the oppor-tunistic infection have been carried out.

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하지동맥폐쇄환자에서의 비해부학적 우회술의 임상적 고찰 (Extra-anatomic bypass for Treatment of Leg Ischemia)

  • 조재호
    • Journal of Chest Surgery
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    • 제27권10호
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    • pp.846-849
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    • 1994
  • Extra-anatomic bypass is indicated for the limb salvage of patients with threatened limb loss especially those who have high risk of infection and death after general anesthesia. We did extra-anatomic bypass procedure nineteen times over a seven year, two month period on sixteen patients. Their mean follow up period was 41.3 months. Male to female ratio was 7:1. Major complaints were resting pain[36.8%], claudication[31.6%], cyanosis[15.8%] and ulcerative change[15.8%]. Associated diseases were hypertension, tuberculosis, chronic renal failure, atrial fibrillation, complete heart block and laryngeal cancer. Postoperative patency rates were 76.9% at 1 year, 72.7% at 2 years and 70% at 3 years. Limb salvage rate was 78.9%. Postoperative mortality rate was 10.5%.

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Serous Fat Atrophy of a Reticulated Giraffe (Giraffa camelopardalis)

  • Yong, Hwan-Yul
    • 한국수정란이식학회지
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    • 제25권4호
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    • pp.297-300
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    • 2010
  • A female reticulated giraffe (Giraffa camelopardalis), 20-month-old, 342 kg, died at Seoul Zoo on January 2, 2009 after a stressful episode of chronic diarrhea. Given the appearances postmortem, it was strongly suspected that the giraffe suffered from malnutrition for a long time. Typical appearances of serous fat atrophy were shown on most fat tissues of body organs such as heart, bone, liver, mesentery and kidney. In this study, the sudden death that had been known as "peracute mortality syndrome" was clearly identified to have resulted from a lack of understanding the Browser's diet and general failure in giraffe husbandry. Individualized care and high quality hay must be provided to compensate higher consumption of metabolic energy and to prevent animal loss in winter season.

당뇨병이 없는 뇌경색 환자에서 발생한 저혈당과 동반된 심정지 (Cardiac Arrest in Conjunction with Hypoglycemia in a Non-Diabetic Patient with Cerebral Infarction)

  • 고정민;이지용
    • 대한신경집중치료학회지
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    • 제11권2호
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    • pp.143-147
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    • 2018
  • Background: Hypoglycemia is uncommon in people without diabetes. There have been only a few reports of cardiac arrest in conjunction with hypoglycemia in non-diabetic patients. Case Report: A 66-year-old man visited the emergency room with dizziness. He was a chronic alcoholic. Laboratory test showed no evidence of diabetes mellitus. Brain magnetic resonance imaging revealed a left cerebellar infarction. Abdomen computed tomography demonstrated liver cirrhosis with minimal ascites. During his hospital stay, he consumed only a small amount of food because of nausea and headache. On hospital day 4, he had a cardiac arrest after two seizure episodes. His blood glucose was 10 mg/dL. The combination of liver cirrhosis, renal failure and poor oral intake was presumed to be the causes of the severe hypoglycemia. Conclusion: We report a rare case of cardiac arrest occurring in conjunction with severe hypoglycemia in a non-diabetic patient with cerebral infarction.

Study on the Correlation Between Occupation and Chronic Degenerative Disease

  • KWON, Lee-Seung;KIM, Su-Hye;JUNG, Min-Jae
    • 웰빙융합연구
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    • 제4권1호
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    • pp.11-18
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    • 2021
  • Purpose: This study aims to explore the correlation between job and hypertension. Hypertension is a major risk factor such as stroke, myocardial infarction, heart failure, and vascular aneurysms. Research design, data and methodology: The data from this study are the 2017 National Health and Nutrition Examination Survey classified into office workers and non-office workers. Frequency analysis was used for general characteristics analysis, and ANOVA test analysis was used for correlation between subjects' basic variables and blood pressure. The post analysis as turey was used to verify the validity of the statistical results. All statistical analyzes were performed using the IBM SPSS 24.0 program. Results: There was a difference in the prevalence of hypertension among office workers and non-office workers.

선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 만성 신장병으로 발전한 사례 (A Case of Progressive FSGS and Chronic Kidney Disease in Congenital Chloride Diarrhea with SLC26A3 Mutation)

  • 서영준;정한빈;안석민;신우철;배은주;윤종형;정활림;이홍진
    • 대한유전성대사질환학회지
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    • 제18권3호
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    • pp.87-94
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    • 2018
  • 선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 말기 신장병으로 발전한 사례를 보고 하고자 한다. 20세 여자 환자로, 본원에서 출생 전 산전진단에서 양수과다 및 초음파 소견으로 선천성 염소성 설사가 의심되었으며, 출생 직후 확진 되어 신생아기 때부터 KCl 보충을 통하여 증상 조절을 시작하였다. 환아는 이후 특별한 건강의 문제가 없었으나 12세에 단백뇨가 관찰되었고, 16세때 본원에서 국소분절 사구체경과증 과 2기 만성신장병 진단을 받았다. 이후 보존적 치료를 하였으며, 지속적인 단백뇨에 대한 재 평가를 위하여 입원하게 되었다. 입원 후 확인된 검사에서 사구체여과율(GFR)은 4기 신장병으로 악화되어 있었으며 신생검에서도 국소분절 사구체신염으로 인한 만성 신장병이 재 확인 되었다. 환아 및 가족을 대상으로 시행한 유전자 검사(diagnostic exome sequencing)에서는 SLC26A3 유전자의(c.2063-1G>T) 동형 접합체 변이가 각각 부모에서 전달된 것을 확인하였다. 선천성 염소성 설사 환자는 적절한 전해질 보충에도 불구하고 신기능 손상이 되기 쉬운 경향이 있으며, 따라서 조기 진단 및 충분한 전해질 보충이 이루어지는 경우에서도 환자의 신장 기능에 대한 정기적 관찰 및 적절한 보조 치료가 필요할 것으로 사료된다.

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