• 제목/요약/키워드: Coronary

검색결과 2,316건 처리시간 0.035초

개심술 치험 50례 (Clinical Experiences of Open Heart Surgery [50 Cases])

  • 임진수
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.692-699
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    • 1985
  • Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

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성인 활로씨 4징증 수술치험 101예 보고 (Surgical Correction of Tetralogy of Fallot in Adults - 101 Cases Report -)

  • 조범구
    • Journal of Chest Surgery
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    • 제21권4호
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    • pp.649-655
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    • 1988
  • One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.

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개심술 180례에 대한 임상적 고찰 (Open Heart Surgery:Clinical Analysis of 180 Cases)

  • 나명훈
    • Journal of Chest Surgery
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    • 제27권6호
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    • pp.460-471
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    • 1994
  • Between Feb. 1990 and Aug. 1993, 180 cases of the open heart surgery were performed under cardiopulmonary bypass in the Department of Thoracic & Cardiovascular surgery, Gil General Hospital. There were 83 cases with congenital heart diseases [CHD] and 97 cases with acquired heart diseases [AHD]. The CHD consisted of 78 acyanotic[mortality: 3.8 %] and 5 cyanotic cases with heart anomaly[mortality:l case]. The AHD were 97 cases, which contained 53 valvular, 27 ischemic heart diseases, 10 aortic diseases, 5 cases with myxoma, 1 case with post-infarct VSD, and 1 case with removal of infected pacing wire in right ventricle. In the 53 valvular heart diseases, there were 45 cases with valve replacement[MVR 27, AVR 9,MVR + AVR 9] and 8 cases with valvuloplasty. The number of the implanted prosthetic valves were 53. In MVR, 25 St. Jude, 6 Sorin, 3 Carpentier-Edward and 2 Intact medical valves were used. In aortic position, 13 St. Jude, 3 Sorin and 1 Intact medical valves were applied. The operative mortality was 5.6 % [3/53]. The annuloplasty applying artificial ring was performed in 17 patients[4 cases associated with MVR] and the number of the implanted ring was 19, which included 14 Duran ring[10 mitral, 4 tricuspid] and 5 Carpentier ring [3 mitral, 22 tricuspid]. In the 27 ischemic heart diseases, there were 9 cases with left main coronary artery lesions, 7 one vessel, 5 two vessels, and 6 three vessels. Average number of anastomosis was 2.8 per patient. The operative mortality was 14.3 % [4/27]. Among the 10 patients with aortic diseases, 7 cases were aortic dissection[type A: 5, type B: 2] and 3 cases were descending thoracic aortic aneurysm. The operative morality occurred in 3 cases. The overall mortality and the operative mortality of congenital and acquired heart disease was 7.8 %, 4.8% and 10.4%, respectively.

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개심술 후 발생한 수혈 관련 이식편대숙주병 -1례 보고- (Transfusion Associated Graft-Versus-Host Disease After Open Heart Surgery)

  • 전양빈;이창하;이재웅;박철현;박국양
    • Journal of Chest Surgery
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    • 제35권6호
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    • pp.471-474
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    • 2002
  • 수혈관련 이식편대숙주병은 동양인에서 개심술후에 주로 보고되는 드물지만 치명적인 병이다. 이는 신선 전혈의 수혈 전 감마선 조사로 예방할 수 있다. 61세 남자환자가 관상동맥수술을 시행받은 후 수혈 관련 이식편대숙주병이 발생하였다. 술후 환자는 두 아들에게서 2단위의 전혈을 수혈받았다. 술후 10일째 퇴원 당시 경미한 설사만 있었다. 퇴원 이틀째 지속적인 설사와 전신적 홍반 및 고열을 주소로 재입원하였다. 임상검사상 간, 신장, 소화기 및 골수의 기능 부전을 보였고, 혈역학적으로 급격히 악화되어 술후 17일에 다발성 장기 기능부전으로 사망하였다. 저자들은 본원에서 심장수술을 시행한 이래 이식편대숙주병을 처음으로 경험하였고, 이 후 전혈수혈에 대한 방침을 수정하였다.

우측상대정맥 없이 좌측 상대정맥이 좌심방으로 유입되는 활로씨 사징증의 수술치험 1례 (Persistent Left Sperior Vena Cava Draining into the Left Atrium with Absent Right Superior Vena Cava in Tetralogy of Fallot)

  • 김혁;김병일;김남수;김영학;정원상;강정호;지행옥;이철범;전석철
    • Journal of Chest Surgery
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    • 제32권12호
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    • pp.1115-1117
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    • 1999
  • A persistent left superior vena cava draining into the coronary sinus is the most benign and widely encountered abnormality and can easily be explained embryologically as the persistence of the usual pattern of vnous circulation in the embryo,. However a persistent left superior vena cava draining into the left atrium with absent right superior vena cava is an extremely rare anomaly. We report this situation in an infant with tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium. In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot.

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수술실 내 경식도 심장초음파검사에서 우연히 발견된 유두상 섬유탄력종 - 1예 보고 - (Papillary Fibroelastoma of the Aortic Valve: Discovered by Chance with Intraoperative Transesophageal Echocardiography - A case report -)

  • 김정원;정종필;박순은;김영민;박창률;신제균
    • Journal of Chest Surgery
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    • 제40권9호
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    • pp.637-640
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    • 2007
  • 유두상 섬유탄력종은 드문 양성 심장 종양으로 대부분 증상이 없으나 전신 색전증의 위험성이 높다. 저자들은 관상동맥우회술을 준비하면서 정기적인 수술실 내 경식도 심장초음파검사를 시행하던 중 우연히 대동맥 판막의 종양을 발견하였다. 좌측 및 우측 대동맥판막 첨판에 부착되어 있던 종양은 수술로 완전절제되었으며, 병리학적 검사에서 유두상 섬유탄력종으로 확진되었다. 이에 저자들은 수술 중 경식도 심장초음파의 중요성에 대하여 문헌고찰과 함께 보고하는 바이다.

메틸사이클로헥산의 독성과 신경에 미치는 영향 연구 (Toxicity of Methylcyclohexane and the Effects on Nervous System)

  • 김현영;김태균;강민구
    • 한국산업보건학회지
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    • 제21권2호
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    • pp.82-89
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    • 2011
  • Methylcyclohexane is frequently used in industrial sites (2,592tons/year) as rubber adhesives, ink, paint thinners, organic solvents, and so on. However, there are limited data on the toxic evaluation of methylcyclohexane. This study aims to predict the hazards and neurological effects of methylcyclohexane using SD rats in order to prevent health disorders of workers. The OECD Guideline for Testing of Chemicals (OECD, 2001) was used as a reference during the tests. For 13 weeks (once a day, five days per week) 0, 10, 100 and 1,000mg/kg/day of methylcyclohexane was injected to SD rats to observe any changes in the body or organ weight, hematology, histopathology, mobility, blood pressure, and neurotransmitter. As a result, some male and female SD rats injected with 1,000mg/kg/day of methylcyclohexane died. On the other hand, surviving rats showed significant changes such as hematological changes involving the decrease in the number of red blood corpuscles, and the decrease or increase in the weight of the lungs, kidneys, spleens, and livers (p< 0.05, p<0.01). Also histopathological lesions were observed in the hearts and kidneys. In the test for the effect on the nervous system, SD rats injected with 100mg/kg/day of methylcyclohexane had higher blood pressure levels compared to the control group. However, no abnormal effects was observed in the mobility, serotonin, neurotransmitter, and the biopsy of the brain and coronary arteries. The study results revealed that the livers, hearts, and kidneys were affected by methylcyclohexane. The absolute toxic dose of methylcyclohexane is 1,000mg/kg/day, NOAEL is 100 mg/kg/day, and it is not a toxic substance to the nervous system.

"상한론"에 나타난 계(悸)와 관련된 처방들의 현대 질환 범위 고찰 (Study on Diseases Scope of Prescriptions Related with the Palpitation in "Shanghanlun")

  • 박미선;김영목
    • 동의생리병리학회지
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    • 제29권1호
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    • pp.1-10
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    • 2015
  • This article is a study on palpitation of which disease cause, disease mechanism and formulas were analyzed with reference to annotations on "Shanghanlun" and "Jinkuiyaolue". And the scope of modern diseases related with palpitation was drawn by research on clinical papers. The source books are "Zhujieshanghanlun" and "Jinkuiyaoluefanglun" and the clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). 13 clauses in "Shanghanlun" and 9 clauses in "Jinkuiyaolue" and 12 formulas are related with palpitation. Disease mechanisms of palpitation were classified as yang deficiency, yin deficiency, qi deficiency, blood deficiency, retained fluid, cold, etc and these days, qi stagnation, phlegm turbidity, blood stasis and fire heat are also considered as disease mechanisms. Modern diseases related with palpitation are arrhythmia(extrasystole, atrial fibrillation, bradycardia, tachycardia, sick sinus syndrome, atrioventricular block), vascular diseases(arterial occlusion, phlebothrombosis, Buerger's disease, coronary artery disease, vasculitis), blood pressure disorder(hypertension, hypotension) and heart diseases such as heart failure, angina pectoris, myocardial infarction, myocarditis, cardiomyopathy, pericardial effusion. And diseases related with psychological change(cardiac neurosis, anxiety neurosis, neurosis, depression, hyperthyroidism, hypothyroidism), pyrexia, anemia, drug intoxication, etc are also related with palpitation. Zhen Wu Tang showing an efficacy in dilating blood vessels and strengthening cardiac function, Wuling Powder with diuretic effect and Fried Glycyrrhizae Decoction acting on the ${\beta}$ receptor are applied to heart failure in different ways. Fried Glycyrrhizae Decoction(308 cases), Zhen Wu Tang(154), Wuling Powder(54), Xiao Chaihu Tang(34), Sini San(20) are reported to have been clinically applied to cardiovascular diseases and Zhen Wu Tang and Wuling Powder mainly applied to heart failure, Fried Glycyrrhizae Decoction, Lizhong Wan, Sini San and Zhen Wu Tang chiefly applied to arrhythmia related diseases. This study focuses on the general research and consideration on clinical applications and is a preliminary study to understand relations between Korean Medicine's symptoms and categories of modern diseases.

Effect of Yacon on Platelet Function in Hypercholesterolemic Rabbits

  • Lim, Yong;Son, Dong-Ju;Kim, Yun-Bae;Hwang, Bang-Yeon;Yun, Yeo-Pyo;Hwang, Seock-Yeon
    • Biomolecules & Therapeutics
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    • 제19권4호
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    • pp.472-476
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    • 2011
  • Hypercholesterolemia indirectly increases the risk of arterial and venous thrombosis by enhancing the ability of platelets to aggregate. Yacon (Smallanthus sonchifolius) is composed of fructooligosaccharides, proteins, minerals and phenolic compounds, and has potential benefits for the management of diabetes. This study investigated whether the consumption of yacon in the diet inhibits platelet aggregation under hypercholesterolemic conditions. Male New Zealand white rabbits were fed one of five dietary interventions: a normal control diet, 0.5% cholesterol diet, 0.5% cholesterol diet+a low dose of yacon (0.5 g/kg body weight given orally each day), 0.5% cholesterol diet+a high dose of yacon (2.5 g/kg body weight given orally each day), or a 0.5% cholesterol diet+lovastatin (2 mg/kg body weight given orally each day). After 8 weeks, blood was collected to measure the amount of collagen- and thrombin-induced platelets present. Yacon inhibited the platelet aggregation induced by low doses of agonists (0.5 ${\mu}g/mL$ collagen and 0.02 units/ml thrombin) in a concentration-dependent manner. In addition, yacon concentration-dependently inhibited collagen-induced arachidonic acid liberation. Moreover, n-hexane, chloroform and ethyl acetate fractions showed a marked and selective inhibition of the platelet aggregation induced by collagen, again in a dose-dependent manner. These fractions, especially that of chloroform, significantly suppressed platelet aggregation. The results of this study demonstrate that when yacon is added to a cholesterol-enriched diet, cholesterol-induced platelet aggregation returns to control levels. This may also be beneficial in preventing atherosclerosis and reducing risk factors for coronary artery disease and stroke.

KR-39038, a Novel GRK5 Inhibitor, Attenuates Cardiac Hypertrophy and Improves Cardiac Function in Heart Failure

  • Lee, Jeong Hyun;Seo, Ho Won;Ryu, Jae Yong;Lim, Chae Jo;Yi, Kyu Yang;Oh, Kwang-Seok;Lee, Byung Ho
    • Biomolecules & Therapeutics
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    • 제28권5호
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    • pp.482-489
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    • 2020
  • G protein-coupled receptor kinase 5 (GRK5) has been considered as a potential target for the treatment of heart failure as it has been reported to be an important regulator of pathological cardiac hypertrophy. To discover novel scaffolds that selectively inhibit GRK5, we have identified a novel small molecule inhibitor of GRK5, KR-39038 [7-((3-((4-((3-aminopropyl)amino)butyl)amino)propyl)amino)-2-(2-chlorophenyl)-6-fluoroquinazolin-4(3H)-one]. KR-39038 exhibited potent inhibitory activity (IC50 value=0.02 µM) against GRK5 and significantly inhibited angiotensin II-induced cellular hypertrophy and HDAC5 phosphorylation in neonatal cardiomyocytes. In the pressure overload-induced cardiac hypertrophy mouse model, the daily oral administration of KR-39038 (30 mg/kg) for 14 days showed a 43% reduction in the left ventricular weight. Besides, KR-39038 treatment (10 and 30 mg/kg/day, p.o.) showed significant preservation of cardiac function and attenuation of myocardial remodeling in a rat model of chronic heart failure following coronary artery ligation. These results suggest that potent GRK5 inhibitor could effectively attenuate both cardiac hypertrophy and dysfunction in experimental heart failure, and KR-39038 may be useful as an effective GRK5 inhibitor for pharmaceutical applications.