• Journal of Korea Association of Health Promotion
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• v.2 no.1
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• pp.9-25
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• 2004

Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items of major health screening program in Korea. Most, of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis), cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infections diseases(hepatitis, tuberculosis, sexually-transmitted diseases, parasites), chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress and earlypsychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests( CBC, urinalysis, liver function tests, lipid tests, glucose, HbA1c, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT) endoscopy(gastroscopy, colonoscopy), sonography (abdomen, thyroid, pelvis, breast), cytology(cervix), bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA125, PSA and eye tests. Advanced technologies, like CT, PET, MRI, MRI/Angio, molecular testing were widly used in hospital based health screening programmes. In summary, a variety of tests were untilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few programs used tests excessvely disregarding health screening subjects.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.243-249
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• 1982

A persistent left superior vena cava draining into the left atrium associated with atresia of the coronary sinus-ostium, ASD, and PDA is a rare congenital anomaly. The patient was a 4 year-old female whose complaints were frequent URI and exertional dyspnea. The congenital heart anomaly was suspected at 2 months of her age. Chest films showed cardiomegaly [C-T ratio, 75%]. EKG, Echocardiography, cardiac catheterization and angiocardiography were performed. Open heart surgery was done under impression of LV-RA shunt, bilateral superior vena cavae, and ASD. At the time of operation, huge LA and RA, inferior vena caval defect of a secundum type ASD [1.5 x 3cm in diameter], absence of innominate vein, atresia of the coronary sinus-ostium, and persistent LSVC draining into LA were noted. Direct suture closure of ASD and ligation of LSVC were done. The patient`s postoperative course was somewhat eventful: systolic murmur at apex remained. Four months after the operation, congestive heart failure attacked a few times. PDA that was overlooked at the time of open heart surgery was detected through postoperative cardiac catheterization in.4 months later. Emergent operation for closure of PDA was performed on the day of recatheterization. After that, patient`s heart failure was easily controlled without any notable problem.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.250-253
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• 1982

A persistent left superior vena cava draining into the left atrium associated with atresia of the coronary sinus-ostium, ASD, and PDA is a rare congenital anomaly. The patient was a 4 year-old female whose complaints were frequent URI and exertional dyspnea. The congenital heart anomaly was suspected at 2 months of her age. Chest films showed cardiomegaly [C-T ratio, 75%]. EKG, Echocardiography, cardiac catheterization and angiocardiography were performed. Open heart surgery was done under impression of LV-RA shunt, bilateral superior vena cavae, and ASD. At the time of operation, huge LA and RA, inferior vena caval defect of a secundum type ASD [1.5 x 3cm in diameter], absence of innominate vein, atresia of the coronary sinus-ostium, and persistent LSVC draining into LA were noted. Direct suture closure of ASD and ligation of LSVC were done. The patient`s postoperative course was somewhat eventful: systolic murmur at apex remained. Four months after the operation, congestive heart failure attacked a few times. PDA that was overlooked at the time of open heart surgery was detected through postoperative cardiac catheterization in.4 months later. Emergent operation for closure of PDA was performed on the day of recatheterization. After that, patient`s heart failure was easily controlled without any notable problem.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.244-249
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• 1984

Surgical treatment of partial endocardial cushion defect was accomplished in Feb. 1984 in this department. The 5 year old male patient had history of frequent upper respiratory tract infection and since his age of 3 years dyspnea on exertion and palpitation were noted but there were no cyanosis and clubbing. A thrill was palpable on the apex and grade IV/IV harsh systolic ejection murmur and diastolic murmur was audible on it. Liver was palpable about 3 finger breadths and no ascites. Chest X-ray revealed increased pulmonary vascularity, moderate cardiomegaly [C-T ratio; 0.69], and enlarged left atrium. EKG showed first degree heart block, RVH, LVH, and LAD. Echocardiogram showed paradoxical ventricular septal movement and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted left to right shunt [Qp:Qs:2.1:1 ] and moderate pulmonary hypertension [60/40 mmHg]. Left ventriculogram showed mitral regurgitation [Grade III/IV] and filling of left atrium and right atrium nearly same time. Operative findings were: 1.Primum type atrial septal defect [3x2 cm] 2.Cleft on the anterior leaflet of mitral valve. 3.No interventricular communication and cleft of tricuspid valve leaflet. The mitral cleft was repaired with 4 interrupted sutures. The primum type atrial septal defect was closed with Dacron patch intermittently at endocardial cushion and continuously remainder. The post operative course was uneventful and discharged on 22nd postoperative day in good general conditions.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.528-535
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• 1987

A clinical study was performed on 164 cases of PDA experienced at the Dept. of Thoracic and Cardiovascular Surgery of Pusan National University Hospital during 6 years from Jan. 1981 to Dec. 1986. It was shown that the PDA was a female-dominant heart disease [male to female ratio, 1:2.8] and two most common symptoms were frequent URI [45.6%] and exertional dyspnea [36.7%]. Continuous machinery murmurs were detected in 143 cases [87.2%], increased pulmonary vascularities [89.0%] and cardiomegalies [63.4%] by chest X-ray. The signs of LVH [43.9%], RVH [3.7%] and BVH [4.9%] were noted on the EKG. Cardiac catheterizations were performed on 67 out of 164 patients and the mean systolic pulmonary artery pressure was 48mmHg [range: 18-131mmHg] and the mean Qp/Qs was 3.1 [range:1.2-8.5] and Rp/Rs below 0.25 was 83.6%. Associated cardiac anomalies were VSD [7.9%], ASD [3.0%], pulmonary valvular stenosis [2.4%] and left persistent SVC [2.4%]. Operative methods were as follows; ligations [145; 88.4%] and divisions [6;3.7%] were performed through the left posterolateral thoracotomies without mortality and the remained cases [13;8.0%] were managed under the cardiopulmonary bypass because of the associated cardiac anomalies. Atelectasis [4.9%] and pneumonia [4.3%] were most frequent postoperative complications and the overall mortality rate was 2.4% [4 out of 164 cases].

• Journal of Chest Surgery
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• v.11 no.3
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• pp.342-347
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• 1978

A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

• Journal of Chest Surgery
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• v.11 no.3
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• pp.333-341
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• 1978

A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.464-470
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• 1995

From Jan 1988 to Dec 1993, 196 consecutive patients with various pulmonary diseases underwent pneumonectomy. Mean age was 54.0 years[range:7-74 . The underlying diseases were lung cancer[154 cases , destroyed lung[29 cases with pulmonary tuberculosis or empyema thoracis and others[13 cases . The overall mortality and complication rate were 5.6% and 14.8%. In the groups of more than and less than 60 years of age, there was significant differences in mortality rate[P=0.004 . In the group of pneumonectomy and pleuropneumonectomy, there was no significant differences in mortality[P=0.164 and complication rate[P=0.052 . In the group of normal and abnormal EKG, there was no significant differences in mortality[P=0.560 and complication rate[P=0.693 . In the preoperative FEV1, preoperative FVC and predicted postoperative FEV1, prognostic cut-off points were 1800cc, 2600cc and 1300cc, and at points, positive predicted value were 12.3%, 10.5%.and 7.7% and negative predicted value were 97.8%, 98.3% and 96.2% respectively. The preoperative FEV1 is the most reliable indicator in assessment of prognosis of pneumonectomy.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.214-217
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• 1997

Electroconvulsive therapy(ECT) is one of the most effective treatment modalities for the treatment of depression, mania, schizophrenia, or other neuropsychiatric disorders. But, reportedly ECT also can produce various forms of cardiac arrhythmia. We experienced a case of ECT-induced arrhythmia(PVC) accompanied with chest pain in a schizophrenic patient during the course of plain ECT. We conclude that there is a possible causal relationship between ECT and cardiac arrhythmia(PVC). The mechanisms of cardiac arrhythmia(PVC) due to ECT may be explained by the effects of ECT to vagal and sympathetic nervous systems. from this case report, We suggest that careful cardiac monitoring before, during, and after ECT with appropriate anesthetic preparation to a patient may enable to minimize the cardiovascular side effects of ECT in the patients with neuropsychiatric disorders.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.4
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• pp.491-505
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• 2009

Purpose: This study was to develop an algorithm for emergency nursing care of dyspneic patients. Methods: This methodological study was done through reviews of medical records and literatures, checklists of emergency nursing care for dyspneic patients, interviews with nurses, and experts' validity. Results: Firstly, the initial assessment confirmed the identification of airway patency, accessory muscle usage, RR, $SpO_2$, v/s, skin color, and mental status. Immediate emergency care provided oxygen, checked ABG, EKG, and chest X-ray, established a semi-fowler position, maintained IV routes, administered medication orders, and conducted careful monitoring. Secondly, if the patient exhibited $SpO_2$ of less than 90%, the nurse considered the patient's condition to be aggravated. Thirdly, if the patient showed improvement of more than 90% $SpO_2$, the nurse administered secondary assessment and carried out specific nursing care. However, if the patient continuously showed $SpO_2$ of less than 80%, the nurse assisted the intubation and then executed ventilator therapy. Conclusions: This study suggests that the algorithm is an effective decision tool and utilizing the algorithm is expected to improve the emergency nursing care for dyspneic patients.