• Tuberculosis and Respiratory Diseases
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• v.48 no.6
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• pp.944-955
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• 2000

Background : In patients with chronic obstructive pulmonary disease(COPD), several factors have been associated with a poor prognosis. These include old age, low $FEV_1$ low diffusing capacity, high alveolar-arterial oxygen pressure difference, and finally cor pulmonale. This study was done to investigate if the ECG signs suggesting cor pulmonale were independent prognostic factors in patients with COPD. Method : We analyzed ECG, pulmonary function data and arterial blood gas values in 61 patients who were admitted through the emergency department with an acute exacerbation of COPD. The ECG signs reflecting cor pulmonale were right strial overloading(RAO), right bundle branch block, right ventricular hypertrophy and low-voltage QRS. The 61 patients were divided into 2 groups ; group I with no ECG signs(n=36) and group II with one or more ECG signs(n=25) suggesting cor, pulmonale. Results : Poor, prognostic factors by univariate analysis were low $FEV_1$, $FEV_1$ % pred., VC % pred., DLco, DLco % pred., $PaO_2$ and $SaO_2$ high $PaCO_2$ presence of ECG signs reflecting cor pulmonale, presence of mental status change, use of mechanical ventilator, and long term use of glucocorticoid. A multivariate analysis indicated that age(risk ratio=1.13, 95% confidence interval 1.05-1.23), DLco % pred. (risk ratio=0,97. 95% confidence interval 0.94-0.99), $PaO_2$ (risk ratio=0.95, 95% confidence interval 0.90-0.99) and RAO(risk ratio=5.27, 95% confidence interval 1.40-19.85) were independent prognostic factors of survival. There was a significant difference in survival between the patients with and without RAO(p=0.038). The survival rates at 1, 2, and 5 years were 94.5%. 81.4%, and 50.0% in patients without RAO and 82.4%, 70.6%, and 27.5% in patients with RAO, respectively. Conclusion : These results suggest that the presence of ECG signs reflecting cor pulmonale is a predictor of survival and that RAO of these ECG signs is a significant independent predictor of survival in patients with COPD.

• The Korean Journal of Nuclear Medicine
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• v.19 no.2
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• pp.87-89
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• 1985

Unresolved major pulmonary embolism (UMPE) is an uncommon condition which causes pulmonary hypertension, cor pulmonale and death. An accurate and prompt diagnosis of UMPE is very important in the management of such patients with pulmonary embolectomy. Follow-up lung scans can lead to earlier diagnosis of UMPE especially on patients who have a history of acute pulmonary embolism in the past and. present with pulmonary hypertension, respiratory insufficiency and cor pulmonale. We report a case of UMPE strongly suggested by follow-up lung scans and subsequently confirmed by pulmonary angiography and postmortem examination.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.609-617
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• 1999

Background: The aims of this study were to assess the etiologies, survival and prognostic factors of patients with chronic cor pulmonale visited Pusan National University Hospital. Methods : This study included 103 patients with chronic cor pulmonale. There were 67 men and 36 women. The diagnosis of chronic cor pulmonale was primarily based on the presence of underlying lung disorder and echocardiographic finding of enlarged or hypertrophied right ventricle. Other clinical data including patients' symptoms and signs, findings of arterial blood gas analysis, hematologic and biochemical laboratory and pulmonary function test were assessed. Results: The most common underlying lung disorder was pulmonary tuberculosis(59.2%) and chronic obstructive pulmonary disease was the next(28.2%). The survival rate was 57% in one year, 45% in two years, and 34% in three years. The prognostic factors were maximal voluntary ventilation(MVV), forced vital capaoity(FVC), $FEV_1$ serum Na, vital capacity(VC), serum albumin and peak expiratory flow(PEF) in univariate analysis. And in multivariate analysis, serum albumin(p=0.0144) and VC(p=0.0078) were statistically significant. Conclusion: Pulmonary tuberculosis was the most important underlying lung disorder in chronic cor pulmonale. The survival rate was 57% in one year, 45% in two years, and 34% in three years. Serum albumin (p=0.0144) and VC(p=0.0078) were statistically significant prognostic factors.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.267-270
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• 1988

The medical record of ECC and pulmonary function test of 297 cases who were dead at hospital or admitted as coal workers' pneumoconiosis were used for the study of the relationship between forced expiratory volume in one second($FEV_{1.0}$) and ECG sign of pulmonale. The incidence of T wave inversion in $V_1$ lead was significantly increased as $FEV_{1.0}$ decrease. The incidence of T wave inversion in $V_1$ lead was over the half in the group of $FEV_{1.0}$ less than 0.7l.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.25-28
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• 1989

Sixty-two medical records of patients with coal workers' pneumoconiosis who died in hospital as coal workers' pneumoconiosis were analysed for study of the relationship between forced expiratory volume in one second ($FEV_1$) and life expectancy in coal workers'pneumoconiosis. In the group who died of asphyxia from hemoptysis, life expectancy were well fitted with $FEV_1$(p<0.05). But others were not well fitted to simple linear regression equation. The prevalence of ECG sign of col pulmonale was more in the group of cardiorespiratory failure than asphyxia group. So, in the case of far advanced cor pulmonale, it was difficult to predict life expectancy by simple linear regression equation

• Journal of Chest Surgery
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• v.20 no.1
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• pp.139-147
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• 1987

in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

• Journal of Chest Surgery
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• v.28 no.4
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• pp.376-380
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• 1995

We experienced 17 skeletal muscle transpositions in chest surgery during the past 8 years. There were 3 female and 14 male patients with ranging from 5 to 71 years of age [ average 47.3 Seventeen patients underwent 27 musele flaps : 11 latissimus dorsi, 6 pectoralis major, 6 serratus anterior and 4 other muscles. An average of 2.0 previous operations was performed. Hospitalization averaged 24 days.Follow up ranged from 7 days to 45 months;There were two postoperative deaths; one, 20 days after from operation due to pneumonia and the other, 130 days after from operation due to cor pulmonale.Fifteen patients who were alive after operation had good results at the time of last follow up.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.98-104
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• 2005

Approximately 1% to 3% of all children have obstructive sleep apnea syndrome (OSAS). OSAS in children can lead to a variety of symptoms and sequalae; impairment of development and quality of life, behavioral and personality disturbance, learning problem, cor pulmonale and hypertension. Diagnosis and treatment of OASA for children are different from those for adults in many respects. Adenotonsillar hypertrophy is major cause of childhood OSAS. Overnight polysomnography in a sleep laboratory is the gold standard for diagnosing childhood OSAS. However, because full polysomnography in children may be difficult to obtain, expensive, and inconvenient, other methods to diagnose OSAS have been investigated. Adenotonsillectomy is the most common surgical treatment of childhood OSAS. But if residual symptoms remained after adenotonsillectomy, it should be considered to additional treatment such as weight control, sleep positional change, and continuous positive airway pressure (CPAP).

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.128-136
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• 1997

Laryngomalacia is the most common cause of stridor in infant. It is a relatively benign self-limiting condition, but in severe cases, it results in obstructive sleep apnea, cor pulmonale , gastroesophageal reflux, failre to thrive, pectus excavatum, respiratory failure and death. When the airway obstruction related to laryngomalacia becomes significant, surgical correction of the underlying laryngeal deformity is indicated. Numerous reports provide evidence to support the trimming supraglottic soft tissue by using either conventional instruments or the surgical laser for treatment of severe laryngomalacia. Recently, authors experienced a case of laryngomalacia with Trisomy 13 (Patau syndrome) which had three times respiratory arrest and was treated with laser aryepiglottoplasty. We report this case with review of the literatures.

• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.5-13
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• 2005

Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease, characterized by irreversible airflow limitation, with a partially reversible component. The pathological abnormalities of COPD are associated with lung inflammation, imbalances of proteinase and antiproteinase, and oxidative stress, which are induced by noxious particles and gases in susceptible individuals. The physiological changes of COPD are mucus hypersecretion, ciliary dysfunction, airflow limitation, pulmonary hyperinflation, gas exchange abnormalities, pulmonary hypertension, cor pulmonale and systemic effects. The airflow limitation principally results from an increase in the resistance of the small conducting airways and a decrease in pulmonary elastic recoil due to emphysematous lung destruction. This article provides a general overview of the pathophysiology of COPD.