• Journal of Chest Surgery
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• 제11권1호
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• pp.81-84
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• 1978

A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

• Journal of Chest Surgery
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• 제39권9호
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• pp.659-667
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• 2006

배경: 저산소증, 공기색전증, monocrotaline 약물 주입 등에 의해 혈관 내막의 손상을 일으켜 폐동맥내세포외간질 단백질 합성을 활성화시키고 혈관의 중막비후나 신생내막의 형성을 일으키는 혈관개조(vascular remodeling) 실험이 활발하게 진행되고 있다. 본 연구는 폐정맥을 폐쇄시킨 후 변화된 혈류에 의해 폐장이 어떻게 반응하는지 확인하고자 동물실험을 실시하였다. 대상 및 방법: $352{\pm}18g$의 흰쥐(n=10)를 이용하여 ketamine 근육내 주사로 마취하여 정중흉골절개술을 시행하고 심장을 노출시킨 후 우측 폐정맥을 크립을 이용하여 폐쇄하였으며, 15일 후 폐동맥압, 좌심실과 심실중격 대비 우심실 무게비(RV/LV+Sweight ratio), 말초 폐동맥의 외측지름대비 벽두께비(percent wall thickness (%WT)) 등을 측정하여 대조군(n=5)과 비교하였다. 결과: 폐정맥 폐쇄군의 폐동맥압은 38{\pm}12 mmHg로 대조군의 $13{\pm}4mmHg$에 비해 의의 있게 증가되었다(p<0.05). 좌심실과 심실중격 대비 우심실 무게비는 대조군의 $0.35{\pm}0.04$에 비해 $0.52{\pm}0.07$로 통계적으로 유의한 우심실 비대 소견을 보였고(p<0.05), 말초 폐동맥의 외측지름대비 벽두께비는 폐쇄군이 $22.4{\pm}6.7%$로 대조군의 $6.7{\pm}3.4%$에 비해 증가되었다(p<0.05). 결론: 한쪽 폐의 폐정맥 폐쇄는 폐동맥고혈압, 우심실 비대, 말초 폐동맥의 중막 비후 소견을 유도하였다. 이는 폐동맥 혈관개조의 병리학적 특성을 나타내는 것으로 일측 폐정맥을 폐쇄하는 경우 반대측 폐장의 폐혈류량 증가뿐만 아니라 혈관개조를 유발하는 내막의 손상을 동반함을 알 수 있었다.

• 한국임상수의학회지
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• 제36권4호
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• pp.207-211
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• 2019

This study was performed to compare the radiographic and echocardiographic features of cardiovascular changes between small and large dogs with heartworm diseases. Total of 49 dogs from two institutions were included in this study. The dogs were diagnosed with heartworm infestation and underwent thoracic and echocardiography. On thoracic radiographs, vertebral heart scale, reverse D shape, main pulmonary artery dilation, peripheral pulmonary artery dilation, and evidence of right heart failure were evaluated. On echocardiographs, visibility of worms, main pulmonary artery to aortic root (MPA/Ao) ratio, right to left ventricular basal diameter (RVD/LVD) ratio, and pulmonary hypertension were evaluated and analyzed between small and large dogs. The proportion of reverse D shape of the heart and accuracy for right ventricular hypertrophy in small dogs were lower than those of the large dogs. For echocardiographic parameter, the MPA/Ao and RVD/LVD ratio in the small dogs were significantly lower than those of the large dogs. As the results, thoracic radiography have a tendency to underestimate the severity of HWD in small dogs and should be used with echocardiography.

• Investigative Magnetic Resonance Imaging
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• 제16권2호
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• pp.189-194
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• 2012

40세 남성에서 상대정맥의 폐쇄와 우폐동맥 협착을 동반한 종격동 종괴가 발견되어 병리학적 소견에 경화성 종격동염으로 진단되었고, 6개월 후 심장 자기공명영상(MRI)에서 비허혈성 심근병증으로 의심된 심장림프종의 예를 보고하고자 한다. 심장 초음파에서 제한적 양상의 심장 생리현상을 보였고 구혈율이 매우 감소되어 있었다. MRI에서 전반적인 심근비대와 조영제 주입 후 광범위한 지연조영증강이 있어 비허혈성 심근병증이 의심되었으며 심장근육 생검 후 림프종으로 확진되었다. 조영제 주입후 MRI에서 심근 기저부는 침범되지 않았고 전반적인 심내막 보존이 있었으므로 아밀로이드증과 구별되는 양상이고 종괴를 형성하지 않았기 때문에 심장종양 보다는 심근병증에 더 유사한 영상 소견을 보인 특이한 증례로서 심장림프종의 자기공명영상에서의 특징을 문헌고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
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• 제39권10호
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• pp.775-778
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• 2006

비후형 심근증은 심근의 부적절한 비대로 유발되며 호흡곤란, 흉통, 실신, 그리고 급사에 이르기까지 다양한 임상 양상을 보인다. 이러한 증상은 주로 좌심실유출로의 협착으로 인해 발생하며 이를 해결하기 위해 심실중격절제술이 고안되었다. 하지만 기존의 고전적인 중격절제슬은 대동맥절개술을 통해 진행되었으며, 이는 심실 중격의 중앙부위에 병변이 존재할 경우 시야 확보의 어려움과 병변으로의 접근이 용이하지 않아 극히 일부분의 심실중격절제술만을 시행할 수밖에 없었다. 따라서 좌심실 유출로의 협착 및 승모판막의 수축기전방운동 등이 완벽하게 해결되지 않는 경우가 흔하였고 이러한 경우 환자의 증상 호전과 생존기간의 연장에도 한계가 있었다. 본 증례에서는 이러한 환아에게서 좌심실 심첨부의 절개를 통해 비후된 유두근과 건삭을 포함한 광범위 중격절제술(extended septal myectomy)을 시행하였다. 수술 후 환아의 증상은 호전되었으며 심초음파 및 방사선학적 소견상 특별한 문제없이 10개월째 외래 경과 관찰 중이다.

• Journal of Chest Surgery
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• 제50권3호
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• pp.144-152
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• 2017

Background: The ubiquitin-proteasome system (UPS) is an important pathway of proteolysis in pathologic hypertrophic cardiomyocytes. We hypothesize that MG132, a proteasome inhibitor, might prevent hypertrophic cardiomyopathy (CMP) by blocking the UPS. Nuclear factor kappa-light-chain-enhancer of activated B cells ($NF-{\kappa}B$) and androgen receptor (AR) have been reported to be mediators of CMP and heart failure. This study drew upon pathophysiologic studies and the analysis of $NF-{\kappa}B$ and AR to assess the cardioprotective effects of MG132 in a left ventricular hypertrophy (LVH) rat model. Methods: We constructed a transverse aortic constriction (TAC)-induced LVH rat model with 3 groups: sham (TAC-sham, n=10), control (TAC-cont, n=10), and MG132 administration (TAC-MG132, n=10). MG-132 (0.1 mg/kg) was injected for 4 weeks in the TAC-MG132 group. Pathophysiologic evaluations were performed and the expression of AR and $NF-{\kappa}B$ was measured in the left ventricle. Results: Fibrosis was prevalent in the pathologic examination of the TAC-cont model, and it was reduced in the TAC-MG132 group, although not significantly. Less expression of AR, but not $NF-{\kappa}B$, was found in the TAC-MG132 group than in the TAC-cont group (p<0.05). Conclusion: MG-132 was found to suppress AR in the TAC-CMP model by blocking the UPS, which reduced fibrosis. However, $NF-{\kappa}B$ expression levels were not related to UPS function.

• 대한임상검사과학회지
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• 제43권4호
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• pp.138-144
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• 2011

Exaggerated blood pressure response during exercise has been found to increase the risk of future hypertension, left ventricular hypertrophy, cerebrovascular stroke, and CVD (cardiovascular disease) death. The aim of this study was to evaluate exercise capacity, cardiovascular factors in exaggerated blood pressure response during treadmill exercise testing. For research subjects, 72 subjects (normal blood response: 49 subjects, exaggerated blood response: 23 subjects) who received treadmill exercise test at J General Hospital were selected in this study. Exaggerated SBP (systolic blood pressure) response was defined as an SBP of 210 mmHg or greater during a maximal treadmill exercise test. The group with an exaggerated SBP response showed significantly higher values for RPP (rate pressure product) compared with the group with a normal SBP response. Subjects with METs (metabolic equivalents) had lower exaggerated SBP response than normal SBP response group. Subjects with recovery SBP had delayed exaggerated SBP response than normal SBP response group. Exaggerated SBP response to exercise is negative correlation with METs.

• Journal of Chest Surgery
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• 제37권10호
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• pp.861-864
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• 2004

역행성 심정지의 사용과 연관된 관상정맥동의 손상은 드물며 사망까지 가능한 합병증이다. 심내막염, 승모판막폐쇄부전증과 심비대를 보인 노인 환자에서 역행성 심정지액 투여 중에 발생한 관상정맥동의 파열과 심장내 복구 방법을 보고한다.

• 대한수의학회지
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• 제47권1호
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• pp.99-102
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• 2007

A 3-year-old, intact female, Shih-tzu dog was presented with a 15-day history of vomiting,depression, and anorexia. On physical examination, systolic ejection murmurs with precordial thril atthe left heart base were detected. A diagnosis of congenital pulmonic stenosis (PS) was made mainlyfrom the thoracic radiography, electrocardiography, and echocardiography. On complete blood counts andconfirmed that main pulmonary artery was tremendously buldged and electrocardiography was suggestiveof severe right ventricular hypertrophy. Echocardiographic findings revealed the pulmonic valve stenosiscontaining valvular dysplasia and poststenotic dilation. On Doppler echocardiography, ejection velocityof the lesion accounted for 3.38 m/sec, meaning mild velocity through the stenotic area. The dog'sproblem and resulted in death. However, there has been no reliable relation between PS and CRF. Primarymalformation of pulmonic valve was confirmed at necropsy after death.

• 한국식품영양학회지
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• 제11권2호
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• pp.171-178
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• 1998

K14 환자는 유방암 수술, 방사선 치료, 피부이식 수술, 무릎 관절통의 기왕력이 있는 고령의 여성 호흡 곤란증 환자로서 문진과 진찰, 혈압, 비만도 측정, 임상병리, 흉부 X-선, 심전도와 심초음파, 폐기능 검사 등 체계적인 심폐기 질환의 진단 결과 비난증과 고혈압, 좌심실 비대, 만성 폐질환의 소견이 있어 심폐기능 모두에서 문제성이 발견되었다. 검사 결과들의 정밀한 판독법 및 장기-치료 관찰 결과를 임상문헌과 함께 고찰하였다.