• 제목/요약/키워드: Heart Disease Prediction

검색결과 38건 처리시간 0.032초

신생아기에 발견된 단독 심실 비치밀화증 1예에서 관찰된 NT pro-BNP의 변화 (Changes in N-terminal pro-B-type natriuretic peptide in a neonate with symptomatic isolated left ventricular noncompaction)

  • 송지현;김여향;김천수;이상락;권태찬
    • Clinical and Experimental Pediatrics
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    • 제52권1호
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    • pp.129-132
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    • 2009
  • 저자들은 청색증과 끙끙거림, 심비대로 전원되어 심장 초음파 검사에서 좌심실에 발생한 단독 심실 비치밀화증을 가진 신생아 1예를 경험하였다. 환자에서 측정한 NT pro-BNP는 높았고, 수유 곤란과 빈호흡을 동반한 심부전 증상이 있었다. 심부전증에 대한 치료에도 불구하고 주기적으로 시행한 NT pro-BNP가 더 높아지면서 환자에게서 급성 심정지가 발생하였고, 심폐소생술 이후 NT pro-BNP가 다시 낮아지면서 심부전 등의 증상은 호전을 보였다. 심초음파 검사와 함께 NT pro-BNP를 주기적으로 검사해 보는 것이 병의 경과를 예측하는데 도움이 될 수 있을 것이다.

활로 4징증에서 폐동맥의 상태와 수술성적과의 관계 (The relationship of pulmonary arterial shunts and the operative results in tetralogy of Fallot)

  • 안재호;서경필
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.644-656
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    • 1984
  • In Tetralogy of Fallot, the most common congenital cyanotic heart disease, the mortality is decreasing continuously with adequate type and timing of operation. At S.N.U.H., 195 patients were operated from January 1982 to December 1983 and 176 patients among them were analysed in the view of pre-operative pulmonary arterial condition measured by cardiac cineangiogram. The most common associated anomaly was PFO and ASD and they did not affect the postoperative course and mortality. The overall mortality rate was 8.5% in 1982 and 6.8% in 1983 but under 2 years of age, the mortality rate was relatively high as 25% in 1982 and 16.7% in 1983, and when transannular patch widening of Right Ventricular Outflow Tract was used, the mortality rate was 12.5% in 1982 and 27.3% in 1983. Preoperative angiographic measurements of the pulmonary arterial status for prediction of the ratio between the Left Ventricular and Right Ventricular peak systolic pressure were calculated retrospectively according to the Blackstones formula, and the predicted value of PRV/LV greater than 0.6 carried apparently high complication and mortality rate as 16.6% M.R. in 1982 and 11.1 % in 1983. Among postoperative complications, c-RBBB occurred most frequently about 50% but did not influenced to mortality, Low Cardiac Output Syndrome was developed in about 40%. If we select the patient who should have the staged operation including shunt operation and choose the type of RVOT relief, we expect the improvement of postoperative clinical results.

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Sedation with dexmedetomidine in elderly patients during dental surgery: a retrospective case series

  • Seto, Mika;Kita, Ryosuke;Kondo, Seiji
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권3호
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    • pp.152-157
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    • 2019
  • Objectives: The number of elderly patients with systemic basal disease requiring invasive dental treatment has increased. Appropriate prediction of surgical invasiveness and combined use of psychosedation are thought to contribute to safe whole-body management. Dexmedetomidine (DEX) exhibits analgesic and anti-anxiolytic properties and causes mild respiratory depression. Studies regarding DEX use in elderly non-intubated patients are scarce. We aimed to use retrospective data to determine an effective dose of DEX to induce adequate sedation in elderly patients undergoing invasive dental surgery under local anesthesia. Materials and Methods: One hundred two patients aged 70 to 96 years were presumably appropriately controlled with sedation. DEX was administered at an initial loading dose of 2.0 to $3.1{\mu}g/kg/hr$ for 10 minutes. We divided the patients into five groups by age and compared their blood pressures and heart rates. Results: In all five groups, blood pressure decreased suddenly at approximately 15 and 20 minutes after DEX administration. A marked decrease in blood pressure was noted in patients aged 75 to 79 years. Conclusion: For elderly patients aged 75 years and above, the initial loading dose of DEX needs to be reduced to lower than half that required for young and middle-age adults.

Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective

  • Roswall, Nina;Weiderpass, Elisabete
    • Journal of Preventive Medicine and Public Health
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    • 제48권1호
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    • pp.1-9
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    • 2015
  • The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

심장 관상동맥 외과 (The Clinical Summary of the Coronary Bypass Surgery)

  • 정황규
    • Journal of Chest Surgery
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    • 제13권3호
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Prognostic Prediction Based on Dynamic Contrast-Enhanced MRI and Dynamic Susceptibility Contrast-Enhanced MRI Parameters from Non-Enhancing, T2-High-Signal-Intensity Lesions in Patients with Glioblastoma

  • Sang Won Jo;Seung Hong Choi;Eun Jung Lee;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Ji-Hoon Kim;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • 제22권8호
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    • pp.1369-1378
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    • 2021
  • Objective: Few attempts have been made to investigate the prognostic value of dynamic contrast-enhanced (DCE) MRI or dynamic susceptibility contrast (DSC) MRI of non-enhancing, T2-high-signal-intensity (T2-HSI) lesions of glioblastoma multiforme (GBM) in newly diagnosed patients. This study aimed to investigate the prognostic values of DCE MRI and DSC MRI parameters from non-enhancing, T2-HSI lesions of GBM. Materials and Methods: A total of 76 patients with GBM who underwent preoperative DCE MRI and DSC MRI and standard treatment were retrospectively included. Six months after surgery, the patients were categorized into early progression (n = 15) and non-early progression (n = 61) groups. We extracted and analyzed the permeability and perfusion parameters of both modalities for the non-enhancing, T2-HSI lesions of the tumors. The optimal percentiles of the respective parameters obtained from cumulative histograms were determined using receiver operating characteristic (ROC) curve and univariable Cox regression analyses. The results were compared using multivariable Cox proportional hazards regression analysis of progression-free survival. Results: The 95th percentile value (PV) of Ktrans, mean Ktrans, and median Ve were significant predictors of early progression as identified by the ROC curve analysis (area under the ROC curve [AUC] = 0.704, p = 0.005; AUC = 0.684, p = 0.021; and AUC = 0.670, p = 0.0325, respectively). Univariable Cox regression analysis of the above three parametric values showed that the 95th PV of Ktrans and the mean Ktrans were significant predictors of early progression (hazard ratio [HR] = 1.06, p = 0.009; HR = 1.25, p = 0.017, respectively). Multivariable Cox regression analysis, which also incorporated clinical parameters, revealed that the 95th PV of Ktrans was the sole significant independent predictor of early progression (HR = 1.062, p < 0.009). Conclusion: The 95th PV of Ktrans from the non-enhancing, T2-HSI lesions of GBM is a potential prognostic marker for disease progression.

Development of Prediction Equation of Diffusing Capacity of Lung for Koreans

  • Hwang, Yong Il;Park, Yong Bum;Yoon, Hyoung Kyu;Lim, Seong Yong;Kim, Tae-Hyung;Park, Joo Hun;Lee, Won-Yeon;Park, Seong Ju;Lee, Sei Won;Kim, Woo Jin;Kim, Ki Uk;Shin, Kyeong Cheol;Kim, Do Jin;Kim, Hui Jung;Kim, Tae-Eun;Yoo, Kwang Ha;Shim, Jae Jeong
    • Tuberculosis and Respiratory Diseases
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    • 제81권1호
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    • pp.42-48
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    • 2018
  • Background: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. Methods: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. Results: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=-10.4433-0.1434${\times}$age (year)+0.2482${\times}$heights (cm); DLco/alveolar volume (VA)=6.01507-0.02374${\times}$age (year)-0.00233${\times}$heights (cm). For women the prediction equations were described as followed: DLco=-12.8895-0.0532${\times}$age (year)+0.2145${\times}$heights (cm) and DLco/VA=7.69516-0.02219${\times}$age (year)-0.01377${\times}$heights (cm). All equations were internally validated by k-fold cross validation method. Conclusion: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.

비 조영증강 비 심전도동기 흉부 CT에서 발견되는 심혈관계 석회화의 임상적 가치 (Clinical Value of Cardiovascular Calcifications on Non-Enhanced, Non-ECG-Gated Chest CT)

  • 최태섭;용환석;김채리;서영주
    • 대한영상의학회지
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    • 제81권2호
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    • pp.324-336
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    • 2020
  • 심혈관계 석회화는 다양한 심혈관계 질환에서 나타나며 심혈관 사건 발생의 표지자의 역할을 한다. CT의 기술이 발전함에 따라 심전도동기 CT뿐만이 아닌 비 심전도동기 CT에서도 심혈관계 석회화를 평가하는 것이 가능해졌다. 이번 종설에서는 비 조영증강 비 심전도동기 흉부 CT에서 발견되는 심혈관계 석회화를 심혈관 사건 발생과 연관되었다고 알려진 3가지 석회화(관상동맥, 흉부 대동맥, 판막 석회화)에 대해 자세히 살펴보고 추가적으로 우연적으로 발견될 수 있는 심막 석회화에 대해서도 간단히 기술하였다. 우리나라에서 2019년 하반기부터 폐암 검진이 시작되면서 고령 흡연자의 비 조영증강 비 심전도동기 저선량 CT의 영상의 수가 늘어나고 있고 이에 우연히 발견되는 심혈관계 석회화도 늘어나고 있다. 그러므로 비 조영증강 비 심전도동기 흉부 CT에서 발견되는 심혈관계 석회화의 의미를 이해하고 적절히 보고하는 것이 영상의학과 의사에게 중요할 것이다.