• The Journal of the Korean dental association
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• v.48 no.3
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• pp.178-183
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• 2010

Obstructive Sleep Apnea(OSA) is a form of sleep disordered breathing(SDB) characterized by the occurrence of episodes of complete or partial upper airway obstruction during sleep that is often quantified as the apnea-hyponea index(AHI). It is increasingly being recognized that OSA is a public health hazard and there is increasing evidence that it is associated with an increase in morbidity. Early recognition and diagnosis of this condition may lead to earlier treatments (eg, CPAP, Oral appliances) with reduction of the risk of metabolic disease, cardiovascular diseases, such as hypertension, ischemic heart disease, arrhythmias and pulmonary hypertension.

• Tuberculosis and Respiratory Diseases
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• v.85 no.3
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• pp.205-220
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• 2022

This study aimed to describe the prevalence of comorbidities associated with chronic obstructive pulmonary disease (COPD) and their relation with relevant outcomes. A systematic review based on the PRISMA methodology was performed from January 2020 until July 2021. The MEDLINE, Lilacs, and Scielo databases were searched to identify studies related to COPD and its comorbidities. Observational studies on the prevalence of comorbidities in COPD patients and costs with health estimates, reduced quality of life, and mortality were included. Studies that were restricted to one or more COPD pain assessments and only specific comorbidities such as osteoporosis, bronchitis, and asthma were excluded. The initial search identified 1,409 studies and after applying the inclusion and exclusion criteria, 20 studies were finally selected for analysis (comprising data from 447,459 COPD subjects). The most frequent COPD comorbidities were: hypertension (range, 17%-64.7%), coronary artery disease (19.9%-47.8%), diabetes (10.2%-45%), osteoarthritis (18%-43.8%), psychiatric conditions (12.1%-33%), and asthma (14.7%-32.5%). Several comorbidities had an impact on the frequency and severity of COPD exacerbations, quality of life, and mortality risk, in particular malignancies, coronary artery disease, chronic heart failure, and cardiac arrhythmias. Comorbidities, especially cardiovascular diseases and diabetes, are frequent in COPD patients, and some of them are associated with higher mortality.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.149-151
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• 2014

Hemangioma of the heart, presenting as a primary cardiac tumor is extremely rare; it accounts for approximately 2% of all primary resected heart tumors. In our patient, the tumor was located in the orifice of the right lower pulmonary vein. Few cases of cardiac hemangiomas have been reported to arise from the left atrial (LA) wall. Left atrial hemangiomas, especially those attached to the LA wall, may be erroneously diagnosed as myxomas. Cardiac hemangioma is a rare disease; furthermore, a tumor arising from the LA wall and misconceived as a myxoma is extremely rare. We removed a mass misdiagnosed as a myxoma; it was pathologically confirmed to be a cardiac capillary hemangioma. Therefore, we report a rare case of a cardiac hemangioma misconceived as a myxoma; the tumor was removed successfully.

• Korean Journal of Veterinary Research
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• v.43 no.2
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• pp.307-310
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• 2003

An atrial septal defect (ASD) is congenital heart disease with a communication between the atria, which allows blood to shoot from the atrium with pressure. A 3-month-old female Miniature Schunauzer was referred to the Veterinary Teaching Hospital of Konkuk University for the evaluation of systolic heart murmur. At presentation, the mucous membrane was cyanotic. On physical examination, an ejection-type systolic murmur was auscultated at the pulmonic area. In addition, thoracic radiography showed enlargement of main pulmonary artery and right atrial/ventricular enlargement. Echocardiography revealed dilated right atrium and atrial septal defect. However, mitral and tricuspid valve were still intact and well tolerating. The presence of an ASD was confirmed by identifying flow across the defect with color Doppler imaging. Doppler echocardiography provides a means of non-invasive documentation and quantification of ASD. Complete blood count and serum chemistry were not remarkable. Although large defect was confirmed between the two atrium, the patient did not show any obvious clinical signs of heart failure at this time.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.133-138
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• 2011

A 4-year-old female Fox Terrier dog (weighting 8 kg) with history of severe abdominal distention and anorexia was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, grade 4/6 systolic murmur heard at the left heart base. Electrocardiography showed right ventricular enlargement (right axis deviation and deep S wave) and right atrial enlargement (P pulmonale). Diagnostic imaging studies revealed hypertrophy of right ventricle, enlargement of right atrium and tricuspid regurgitation and turbulence in the pulmonary artery in right parastenal short axis view. Based on the diagnostic findings, the dog was diagnosed as a case of valvular pulmonic stenosis.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1236-1240
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• 2008

Smith-Lemli-Opitz syndrome (SLOS) is a rare, autosomal recessive disease caused by an inborn error in cholesterol synthesis. Patients with this disease suffer from multiple malformations due to reduced activity of 7-dehydrocholesterol reductase (DHCR7), which increases 7-dehydrocholesterol (7DHC) and 8-dehydrocholesterol (8DHC) concentrations and decreases cholesterol concentration in body fluids and tissue. The SLOS phenotypic spectrum ranges from a mild disorder with behavioral and learning problems to a lethal disease characterized by multiple malformations. Here, we describe a newborn male with ambiguous genitalia who was diagnosed to have type II SLOS during the neonatal period. A clinical examination revealed low levels of unconjugated estriol in the maternal serum, and a variety of fetal ultrasound anomalies, including prenatal growth retardation. After birth, the infant was diagnosed to have congenital heart disease (Tetralogy of Fallot with severe pulmonary artery stenosis), cleft lip and palate, micrognathia, postaxial polydactyly, ambiguous genitalia, and cataracts. Clinical investigation revealed extremely low plasma cholesterol levels and the presence of mutation (homozygote of p.Arg352Gln) in the DHCR7 gene. The patient underwent palliative heart surgery (to widen the pulmonary artery) and received intravenous lipid supplementation. Cholesterol levels increased slightly, but not to normal values. The patient died from cardiopulmonary failure and sepsis 72 days after birth. This report provides the first description of a Korean patient with SLOS confirmed by verification of DHCR7 gene mutation and illustrates the need for early recognition and appropriate diagnosis of this disease.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.94-99
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• 2014

Background: Surgical repair of a partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) may be complicated by sinus node dysfunction or SVC obstruction. We modified the Warden procedure by using a right atrial auricular flap to decrease the occurrence of these complications. Methods: Between February 2005 and July 2012, 10 consecutive patients underwent a modified Warden procedure to correct PAPVC. The median patient age was 5.7 years. Eight patients (80%) had an atrial septal defect. To surgically correct the PAPVC, we made a U-shaped incision on the right atrial appendage and sutured the flap to the posterior wall of the SVC. The anterior wall was reconstructed with various patch materials. Results: No early or late deaths occurred, nor did any patient require early or late reoperation for SVC or pulmonary venous obstruction. No new arrhythmias appeared during follow-up, which was complete in all patients (mean, 29.5 months). Conclusion: Our modification of the Warden procedure seems to be effective and safe. This technique may lower the risk of SVC obstruction, pulmonary venous obstruction, and sinus dysfunction.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1256-1256
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• 2005

Pulmonary atresia with intact ventricular septum (PAIVS) is rare, less than 1% of congenital heart disease. It needs a therapeutic approach according to its individual morphologic feature. Surgical treatment of valvotomy and modified Blalock-Taussig shunt or non-surgical interventional catheter balloon valvuloplasty can be used for mild to moderate hypoplasia of right ventricle. Fontan operation can be considered for less optimum morphological substrate of two ventricular repair. A 3-day-old male neonate was admitted with cyanosis and cardiac murmur. On echocardiogram, he had membranous pulmonary atresia with intact ventricular septum, normal sized tripartite right ventricle, large atrial septal defect with right-to-left shunt, small sized patent ductus arteriosus, and moderate tricuspid regurgitation. He was treated with intravenous continuous infusion of prostaglandin $E_1$ ($PGE_1$) at once. On the third day of hospitalization, Balloon valvuloplasty was performed. After insertion of patent ductus arteriosus stent on the tenth day, $PGE_1$ infusion was discontinued. On the fifteenth day, he was discharged. Now, he is 9 months old and has nearly normal cardiac structure and function with 97% of percutaneous oxygen saturation.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.343-352
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• 2001

Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01). The isovolumetric contraction time/ejection time($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), the isovolumetric relaxation time/ejection time($0.29{\pm}0.16$ vs. $0.15{\pm}0.08$, p<0.05)and the preejection period/ejection time ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05) were prolonged and the ejection time ($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$ msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the $FEV_1$ (r=-0.46, p<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted $FEV_1$) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.274-282
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• 2002

Background: Paravalvular leakage or false aneurysm developed after isolated aortic valve replacement(AVR) for aortic regurgitation(AR) associated with Behcet's disease is one of the most serious complications, and requires subsequent reoperations. We describe the surgical result of homograft aortic root replacement(ARR) for AR associated with Behcet's disease. Material and Method: From January 1992 to December 2001, 6 patients with AR associated with Behcet's disease underwent 7 ARR with homograft and 1 Ross operation. Five patients were male and one was female. The grafts used for ARR were 5 aortic and 2 pulmonic homografts. Ages at operation ranged from 27 to 51 years(mean, 37$\pm$9 years). Two patients underwent ARR with aortic homograft at the first operation. In the remaining 4 patients, ARR using a homograft was performed for paravalvular leakage that developed after AVR, and the mean interval from AVR to ARR was 21 $\pm$29 months(range, 5 to 73.3 moths, median, 7.6 months). Result: There was no early death. All patients were followed up for an average of 18.9$\pm$24.0 months(range, 1.9 to 68.9 months, median, 8.4 months). Two of 4patients who had undergone ARR after AVR required subsequent reoperations for false aneurysm of the ascending aorta and failure of pulmonary homograft. One patient underwent re-replacement of the aortic root, ascending aorta and partial aortic arch with an aortic homograft, the other underwent Ross operation. Conclusion: This study suggests that aortic root replacement using a homograft in aortic regurgitation with Behcet's disease may provide good clinical results and decrease the incidence of paravalvular leakage or false aneurysm after aortic valve replacement. However, the adequate perioperative management and complete removal of the inflarrunatory tissue at operation were also important for the good long-term results.