• 제목/요약/키워드: Coronary intervention

검색결과 231건 처리시간 0.021초

혈관 수술 후 심장 합병증 발생을 예측하기 위한 선별 검사로서 심근 관류 단일 광자 단층촬영의 유용성에 대한 연구 (Myocardial Perfusion SPECT as a Screening Test before Planned Vascular Surgery for Predicting Perioperative Cardiac Complications)

  • 이형채;황윤호;위진홍;전희재;이양행;조광현
    • Journal of Chest Surgery
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    • 제43권1호
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    • pp.25-32
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    • 2010
  • 배경: 혈관질환 환자는 관상동맥질환 및 심장질환을 많이 동반함으로 인하여 혈관 수술 후 잠재되어 있는 심장질환이 악화 또는 유발될 수 있는 가능성이 있다. 이러한 심장질환을 확인하기 위한 검사중 비교적 간단하고 비침습적인 SPECT 촬영에 대한 효용성은 아직 논란이 되고 있다. 본 연구에서는 수술 전 SPECT를 촬영하고, 그 결과에 따른 검사 및 처치들이 혈관 수술 후 심장 합병증 발생에 미치는 임상적인 효과를 평가하고자 한다. 대상 및 방법: 2004년 4월부터 2007년 9월까지 3년 6개월간 본 병원에서 혈관 수술 전 아데노신 부하 Tc-99m 테트로포스민 SPECT를 촬영한 63명의 환자를 대상으로 하였다. 결과: SPECT 촬영 유소견의 심장 합병증 발생 예측에 대한 민감도와 특이도는 각각 41.2%와 52.2%로 비교적 낮게 나왔다. 그러나 비정상적인 SPECT 촬영결과를 보인 환자에게 관상동맥 조영술을 시행하고 관상동맥 병변에 대한 비정상 소견이 있을 때 관상동맥 중재적 시술 및 관상동맥 우회로술 등의 적극적인 처치를 한 경우 심장 합병증의 발생률이 낮은 경향을 보였다. 결론: SPECT 촬영은 혈관수술 후 심장 합병증 발생위험을 예측하기 위한 선별검사로서 효용성이 떨어진다.

관상동맥우회술 대상자의 건강관련 삶의 질 영향요인 (Factors Influencing Health-related Quality of Life in Patients with Coronary Artery Bypass Graft)

  • 김지영
    • 한국산학기술학회논문지
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    • 제17권5호
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    • pp.164-172
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    • 2016
  • 본 논문은 관상동맥우회술 대상자의 사회적지지, 우울, 건강관련 삶의 질의 관계를 규명하고자 하였다. 서울시 S 상급종합병원에서 관상동맥우회술을 받고 외래에 내원한 환자 134명을 대상으로 설문지를 이용하여 자료 수집하였고, SPSS WIN 21을 이용하여 통계 분석하였다. 신체적 건강관련 삶의 질은 연령(F=4.616, p=.004), 성별(t=3.657, p<.001), 교육정도(F=7.688, p=.001), 직업(t=-4.363, p<.001), 배우자(t=-3.065, p=.003), 기저질환(F=3.078, p=.030)에 따라 유의한 차이를 보였다. 정신적 건강관련 삶의 질은 성별(t=2.243, p=.027), 월수입(F=2.821, p=.041)에 따라 유의한 차이를 보였다. 사회적지지는 우울(r=-.415, p<001)과 통계적으로 유의한 부적 상관관계가 있었으며, 정신적 건강관련 삶의 질(r=.261, p=.002)과 유의한 정적 상관관계가 있는 것으로 나타났다. 우울은 신체적 건강관련 삶의 질(r=-.459, p<.001), 정신적 건강관련 삶의 질(r=-.554, p<.001)과 각각 통계적으로 유의한 부적 상관관계가 있었다. 관상동맥질환자의 신체적 건강관련 삶의 질 영향요인은 우울, 기저질환이었고, 설명력은 36.7%이었으며, 정신적 건강관련 삶의 질 영향요인은 우울이었고, 설명력은 34.1%이었다. 관상동맥우회술 후 최적의 건강관련 삶의 질을 위해 우울을 주요 요인으로 하는 표준화된 간호 중재를 개발할 필요가 있다.

스텐트 혈전에 의한 재발성 심실성 빈맥을 동반한 급성 심근경색에 경피적 심폐순환보조 (Percutaneous Cardiopulmonary Bypass Support in a Patient with Acute Myocardial Infarction by Stent Thrombosis Complicated with Ventricular Tachycardia)

  • 김상필;이준완
    • Journal of Chest Surgery
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    • 제39권5호
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    • pp.399-402
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    • 2006
  • 스텐트 혈전증은 경피적 관상동맥 중재술의 드문 합병증으로 치명적인 결과를 일으킬 수 있다. 저자들은 스텐트 혈전에 의한 심인성 쇼크와 심실성 빈맥이 동반된 급성 심근경색 환자 1예를 경피적 심폐 순환 보조 요법으로 성공적으로 치료하였기에 보고하고자 한다.

트랜스지방산이 건강에 미치는 영향 (Trans Fatty Acids and Health)

  • 서정희
    • Journal of Dairy Science and Biotechnology
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    • 제27권2호
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    • pp.25-36
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    • 2009
  • Trans fatty acids (TFAs), especially elaidic acid, formed during partial hydrogenation of vegetable oils have been shown to increase LDL-cholesterol (LDL-C) and decrease HDL-cholesterol (HDL-C), thereby increasing the LDL-C/HDL-C ratio and elevating the risk of cardiovascular disease. However, studies on the health effects of ruminant TFAs have suggested that these TFAs, which are primarily vaccenic acids, have no or inverse association with coronary heart disease. Thus, dietary recommendations or legislation for TFAs should consider the differences in the physiological effects of TFAs derived from various food sources. This present review recapitulates the progress in TFA research by analyzing recent epidemiological studies or intervention studies and comparing the cardiovascular health effects of industrially produced TFA and ruminant TFA.

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2 세 이하 유아기의 개심술 (Open heart surgery in the first two years of life)

  • 성숙환
    • Journal of Chest Surgery
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    • 제15권4호
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    • pp.373-380
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    • 1982
  • Experience with intracardiac surgery in infants indicates that for most anomalies the operation and late mortality after primary total correction is lower than the combined mortality after early palliation and delayed correction. In addition, there are secondary benefits of primary total correction in terms of reversal of retarded physical growth and social development and alleviation of parental anxiety. One hundred and fifteen infants under 2 years of age with congenital cardiac anomalies underwent primary surgical intervention at Seoul National University Hospital from Jan. `78 to Sep. `82. There were 70 patients with VSD, 17 patients with TOF, 10 patients with TGA, 4 patients with ASD, 4 patients with TA, 3 patients with TAPVR, and the remainders are Coronary AV Fistula, partial ECD+COA, SV, DORV, PA, Trilogy+PDA. The overall surgical mortality was 18.3%. In acyanotic group 6 patients died among 76 operated patients, and surgical mortality was 6.6%. But in cyanotic group, the mortality was very high as41.0% [16 patients among 39 patients]. This poor surgical result in cyanotic group was due to Improper pre-, intra- and post-operative care, and we are convincing that these factors soon be improved as experiences accumulated.

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Low Density Lipoprotein(LDL), Atherosclerosis and Antioxidants

  • Ryu, Beung-Ho
    • Biotechnology and Bioprocess Engineering:BBE
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    • 제5권5호
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    • pp.313-319
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    • 2000
  • A crucial and causative role in the pathogenesis of atherosclerosis is believed to be the oxidative modification of low density lipoprotein (LDL). The oxidation of LDL involves released free radical driven lipid peroxidation. Several lines of evidence support the role of oxidized LDL in atherogenesis. Epidemiologic studies have demonstrated an association between an increased intake of dietary antioxidant vitamins, such as vitamin E and vitamin C and reduced morbidity and mortality from coronary artery diseases. It is thus hypothesized that dietary antioxidants may help prevent the development and progression of atherosclerosis. The oxidation of LDL has been shown to be reduced by antioxidants, and, in animal models, improved antioxidants may offer possibilities for the prevention of atherosclerosis. The results of several on going long randomized intervention trials will provide valuahle information on the efficacy and safety of improved antioxidants in the prevention of atherosclerosis. This review a evaluates current literature involving antioxidants and vascular disease, with a particular focus on the potential mechanisms.

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PCI시술시 혈소판 당단백 GP IIb/IIIA 억제제(Abciximab) 투여의 경제적 가치 (Economic Value of Platelet Glycoprotein IIb/IIIA Receptor Blocker (Abciximab) for Percutaneous Coronary Intervention)

  • 김진현;신상진;김은주;이영희
    • 약학회지
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    • 제51권3호
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    • pp.186-193
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    • 2007
  • This study was performed to analyse the economic value of abciximab which is used in PCI to prevent high-risk patients with ischemic complications. The effectiveness of abciximab was extracted from published clinical trials by search-ing CCIS, and the direct medical costs relevant to using abciximab were estimated from the NHI claims database. The results in terms of cost per life-year gained (LYG) and cost per QALY gained showed that abciximab was cost-effective enough to deserve its cost. Social net benefit resulting from abciximab in PCI was estimated to be 60-70 billion Won per year.

Mallory-Weiss Tear After Cardiopulmonary Resuscitation in a Patient Suffering From Acute Myocardial Infarction

  • Yu, Jin Seok;Ko, Woo Suk;Kim, June Hyun;Bae, Kwang Uk
    • 고신대학교 의과대학 학술지
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    • 제33권2호
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    • pp.235-239
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    • 2018
  • A report of a 79 year old male patient suffering from acute myocardial infarction with Mallory-Weiss tear after successful cardiopulmonary resuscitation(CPR) by emergency medical technician in the swimming pool is presented. Successful percutaneous coronary intervention(PCI) was done after appropriate transfusion. The patient survived and discharged without major complications after admitting 11days in the hospital. Importance of CPR in AMI patient is reiterated as complication such as Mallory-Weiss tear may arise.

CT Angiography 영상에서 대동맥 추출을 위한 혈관 분할 알고리즘 성능 평가 (Performance evaluation of vessel extraction algorithm applied to Aortic root segmentation in CT Angiography)

  • 김태형;황영상;신기영
    • 한국정보전자통신기술학회논문지
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    • 제9권2호
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    • pp.196-204
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    • 2016
  • 세계보건기구협회에의 통계에 따르면 심장 혈관 질환의 발병률이 가장 높은 것으로 알려져 있다. CTA영상을 사용하여 관상동맥 및 대동맥 질환을 치료 및 검사할 수 있다. 혈관을 3차원으로 복원하는 과정이 의사의 숙련도에 따라 결과가 상이하며 복원 시간이 길다는 단점이 있으며 이를 극복하고자 자동으로 정확한 혈관을 추출하는 연구들이 진행되어 왔다. 본 논문에서는 자동 및 반자동 분할 기법인 Region Competition, Geodesic Active Contour(GAC), Multi-atlas based segmentation, Active Shape Model(ASM) 알고리즘을 CTA영상에 적용하여 대동맥 기부를 추출하였으며 하우스도르프 거리, 볼륨, 영상처리속도, 사용자 관여 여부, 그리고 관상동맥 심문 검출률을 비교 및 분석하였다. 추출된 3차원 대동맥 모델 중 가장 높은 정확도를 나타낸 알고리즘은 GAC인 반면 사용자 관여가 가장 높았기 때문에 실제 시술에 적용하기 위해서는 자동 분할 알고리즘 개선이 필요하다

흡연자와 비흡연자의 행동양상 연구 (A Study on Behavior Patterns Between Smokes and Non-Smokers)

  • 김화신
    • 대한간호학회지
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    • 제20권1호
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    • pp.79-87
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    • 1990
  • Clinical and epedemiologic studies of coronary heart disease(CHD)have from time to time over the last three decades found associations between prevalence of CHD and behavioral attributes and cigarette smoking. The main purpose of this study is reduced to major risk factor of coronary heart disease through prohibition of smoking and control of behavior pattern. The subjects consisted of 120 smokers and 90 non-smokers who were married men older than 30 years working in officers. The officers were surveyed by means of questionnaire September 26 through October 6, 1989. The Instruments used for this study was a self-administered measurement tool composed of 59 items was made through modifications of Jenkuns Activity Survery(JAS). The Data were analysed by SAS(Statistical Analsis System) program personal computer. The statistical technique used for this study were Frequency, x$^2$-test, t-test, ANOVA, Pearson Correlation Coefficient. The 15 items were chosen with items above 0.3 of the factor loading in the factor analysis. In the first factor analysis 19 factors were extracted and accounted for 86% of the total variance. However when the number of factors were limited to 3 in order to derive Jenkins classification, three factors were derived. There names are Job-Involvement, Speed & Impatience, Hard-Driving. Each of them includes 21 items, 21 and 9, respectively. The results of this study were as follow : 1. The score of the smoker group and non-smoker group in Job-Involvement(t=5.7147, p<0.0001), Speed & Impatience(t=4.6756, p<.0001), Hard-Driving(t=8.0822, p<.0001) and total type A behavior pattern showed statistically significant differences(t=8.1224, p<.0001). 2. The score of type A behavior pattern by number of cigarettes smoked daily were not statistically significant differences. 3. The score of type A behavior pattern by duration of smoking were not significant differences. It was concluded that the relationship between smokers and non - smokers of type A behavior pattern was statistically significant difference but number of cigarettes smoked daily and duration of smoking were not significant differences. Therefore this study is needed to adequate nursing intervention of type A behavior pattern in order to elevated to educational effect for prohibition of cigarette smoking.

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