• Journal of Chest Surgery
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• v.24 no.11
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• pp.1068-1073
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• 1991

Bleeding after open heart surgery with cardiopulmonary bypass was a cause of concern. requiring reexploration of the chest in approximately 8 percent of patients who have had operations on the heart. From April., 1983 to October, 1991, 16 patients[2%] out of 777 patients who underwent open cardiac surgery had emergency reexploration with bleeding at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. In 12 cases[75%], reexploration was performed for continuous bleeding and the reminder[4 cases] were performed for suspected tamponade & hypotension. There were 9 cases[56%] of congenital heart disease and 7 cases of acquired heart disease. The mean blood loss were 997$\pm$472ml /sq. M in total cases and 1442$\pm$ 647ml /sq. M in cases repair of cyanotic heart disease. The mean interval till reoperation was 16.6hr [1hr~72hr] and 41 hr[12~72hr] in tamponade cases and 8.4hr[1hr~24hr] in continuous bleeding cases. The bleeding sites were identified in 7 cases: aortotomy site in 2 cases, ventriculotomy site, SVC, thymus, pleura and sternum wiring site in each other case. But no specific sites was found in the remaining 9 cases. The 8 cases had complications but all except 1 cases with hypoxic brain damage were recovered without sequale. We conclude that emergency thoractomy after open heart surgery may be lifesaving and-/or diminishing complications with bleeding if performed promptly with excessive bleeding, tamponade and unexpected hypotension.

• Korean Circulation Journal
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• v.54 no.7
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• pp.398-406
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• 2024

Background and Objectives: Optimal anticoagulation in very elderly patients is challenging due to the high risk of anticoagulant-induced bleeding. The aim of this study was to assess outcomes of on-label reduced-dose edoxaban (30 mg) in very elderly patients who had additional risk factors for bleeding. Methods: This was a multi-center, prospective, non-interventional observational study to evaluate the efficacy and safety of on-label reduced-dose edoxaban in atrial fibrillation (AF) patients 80 years of age or older and who had more than 1 risk factor for bleeding. Results: A total of 2448 patients (mean age 75.0±8.3 years, 801 [32.7%] males) was included in the present study, and 586 (23.9%) were 80 years of age or older with additional risk factors for bleeding. Major bleeding events occurred frequently among very elderly AF patients who had additional bleeding risk factors compared to other patients (unadjusted hazard ratio [HR], 2.16; 95% confidence interval [CI], 1.16-4.02); however, there were no significant differences in stroke incidence (HR, 1.86; 95% CI, 0.98-3.55). There were no significant differences for either factor after adjusting for age and sex (adjusted HR, 1.65; 95% CI, 0.75-3.62 for major bleeding; adjusted HR, 1.13; 95% CI, 0.51-2.50 for stroke). Conclusions: In very elderly AF patients with comorbidities associated with greater risk of bleeding, the incidence of major bleeding events was significantly increased. In addition, risk of stroke showed tendency to increase in same population. Effective anticoagulation therapy might be important in these high-risk population, and close observation of bleeding events might also be required.

• The Plant Pathology Journal
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• v.20 no.3
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• pp.192-195
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• 2004

A survey on ornamental diseases in 2000 and 2001 showed frequent occurrence of blight symptoms on leaves and stems of columbine and bleeding heart in botanical gardens of Gangwon and Chungnam provinces in Korea. A total of 65 isolates of Streptobotrys sp. were obtained from the infected leaves and stems of the two plants. All isolates were identified as Streptobotrys caulophylli based on their morphological and cultural characteristics. Blight symptoms were induced on leaves of the two plants by artificial inoculation with the isolates. This is the first report that S. caulophylli causes leaf and stem blight on columbine and bleeding heart in the world.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.26-35
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• 1988

The effect of cardiopulmonary bypass on platelet count, platelet function, and bleeding time was studied in 60 patients. Platelet count was significantly reduced during and after cardiopulmonary bypass. Platelet function also had a reduced aggregation response to adenosine diphosphate. Bleeding time was prolonged to over 30 minutes during cardiopulmonary bypass and not returned to normal level until postbypass 1 hour. The amount of postoperative bleeding was proportional to the degree of decrease in platelet count and function, degree of decrease in platelet count and function. There was no significant correlation between duration of cardiopulmonary bypass and platelet count, platelet function, bleeding time, or amount of postoperative bleeding. Patients with cyanotic congenital heart disease showed a larger amount of postoperative bleeding than patients with acyanotic congenital heart disease [P<0.01], and this difference was due to the fact that platelet function was more significantly affected by cardiopulmonary bypass in cyanotic group. Patients using membrane oxygenator showed a less amount of postoperative bleeding than patients using bubble oxygenator [p<0.005] reflecting better preservation of platelet count and function by membrane oxygenator.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.167-173
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• 1980

From 1976 through June 1980, 75 patients underwent Open heart operation at Korea University Hospital.Of the 75 patients, 39 were congenital heart cases and 36 were acquired heart disease cases. 39 cases of congenital heart disease were consisting of 16 T.O.F.,4 A.S.D., 10 V.S.D., 3 P.S., 1 P.D.A., 1 V.S.D. + Mi, 1 Truncus arteriosus, 1 Ebstein, 1 D.C.R.V., 1 Single ventricle. Among 36 valvular replacement cases, 18 cases of MVR, 3 cases of AVR, 6 cases of Double valve replacement, and 10 cases of Open Mitral commissurotomy, were performed. Postoperative mortality rate of congenital heart disease was 25.6% and that of acquired heart disease was 8.3%. Overall mortality rate of open heart surgery was 17.3%. Among 16 cases of postoperative death cases, 5 cases of autopsy were performed. Postoperative cause of death of our series were intracranial bleeding, pacemaker failure, low output syndrome, protamine anaphylaxis, bleeding, prosthetic valve embolism, C V A, miliary tuberculosis, hypothermia due to pump failure.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.824-832
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• 1994

Recently we developed the concept of totally implantable electrohydraulic artificial heart. We tested the artificial heart which was drived by external compressive air in the calves. All three calves had pneumonia before surgery, so postoperative course was not only bad but also the results was not good. The first calf died severe pneumonia on 76th day, the second calf died from troublesome bleeding and uncertain allergic like reaction, and the third died because of bleeding. However, the performance of the artificial heart was good, and especially the blood contacting surface showed excellent hemocompatibility. The anatomic fitting was also very good even in the 35 Kg small newborn calf. During treadmill test, the first calf did not well tolerate for 1 minute but by the Full Fill Full Empty control method the artificial heart responsed well to the physiologic needs. In conclusion, the artificial heart had the very good hemocompatible surface, however, the volume of the artificial heart was a little deficient for the calf and the control algorithm needed further development.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.195-204
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• 2024

Background: Extracorporeal membrane oxygenation (ECMO) is an intervention for severe heart and lung failure; however, it poses the risk of complications, including gastrointestinal bleeding (GIB). Comprehensive analyses of GIB in patients undergoing ECMO are limited, and its impact on clinical outcomes remains unclear. Methods: This retrospective study included 484 patients who received venovenous and venoarterial ECMO between January 2015 and December 2022. Data collected included patient characteristics, laboratory results, GIB details, and interventions. Statistical analyses were performed to identify risk factors and assess the outcomes. Results: GIB occurred in 44 of 484 patients (9.1%) who received ECMO. Multivariable analysis revealed that older age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.06; p=0.0130) and need to change the ECMO mode (OR, 3.74; 95% CI, 1.75-7.96; p=0.0006) were significant risk factors for GIB, whereas no association was found with antiplatelet or systemic anticoagulation therapies during ECMO management. Half of the patients with GIB (22/44, 50%) underwent intervention, with endoscopy as the primary modality (19/22, 86.4%). Patients who underwent ECMO and developed GIB had higher rates of mortality (40/44 [90.9%] vs. 262/440 [59.5%]) and ECMO weaning failure (38/44 [86.4%] vs. 208/440 [47.3%]). Conclusion: GIB in patients undergoing ECMO is associated with adverse outcomes, including increased risks of mortality and weaning failure. Even in seemingly uncomplicated cases, it is crucial to avoid underestimating the significance of GIB.

• The Journal of Korean Medicine
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• v.21 no.3
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• pp.220-224
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• 2000

After stroke, there are many cases of gastro-intestinal bleeding in patients with dysphagia who are fed by Levin tubes. Ulcers in the stomach and duodenum are occasionally produced by psychiatric stress, irritation with the Levin tube and central nerve rusturbances. Because Dansambohyul-tang has been used to treat deficiency of blood, alleviate pain, tranquilize and to treat patients differentiated with an insufficiency of the heart and the spleen in oriental medicine, we treated a 62 year-old male patient who suffered from gastric ulcers with gastro-intestinal bleeding after stroke, and who was differentiated with an insufficiency of the heart and the spleen with Dansambohyul-tang, herb complex. After 20 days of treatment with Dansambohyul-tang, we observed improvement in the gastric ulcer through gastroscopy; serum hemoglobin increased by 5.1g/dl after 2 months; and symptoms (pale complexion.dysphagia.general weekness) were alleviated. So Dansambohyul-tang shows therapeutic effects on gastric ulcers with gastro-intestinal bleeding after stroke.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.672-677
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• 1986

From April, 1984 to August, 1986, 214 cases of cardiovascular surgeries had been performed at Yeungnam University Hospital consisting 158 open heart surgeries and 56 non-open heart surgeries. The leading cardiac anomaly of open heart surgeries was ventricular septal defect which was 43% of congenital heart diseases, and most of remaining non-open heart surgeries were ligating patent ductus arteriosus. We had observed 33 postoperative complications such as wound problems, transient arrhythmia, postpericardiotomy syndrome, bleeding requiring reoperation and so on. 3 cases of surgical mortality were present [2 in congenital heart diseases and 1 in acquired heart disease], which resulting 1.9% of surgical mortality rate in the open heart surgeries.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.2
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• pp.177-186
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• 2010

This study is about researching DongEuiBoGam by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of essence, spirit, qi and blood in NaeGyungPyeb of DongEuiBoGam are these. In Essence, this explain mechanism of disease patterns those are seminal emission, dream emission, spermatorrhea, white ooze. These disease pattern's mechanisms are kidney yang deficiency, kidney yin deficiency, heart yang deficiency, heart yin deficiency, heart qi deficiency, spleen qi deficiency and so on. On viewpoints of viscera and bowels they are related with heart, kidney, spleen. And most of them are deficiency from deficiency-excess Pattern Identification. Classifying disease pattern of qi is about upward, downward movement and more concentrated deficiency than excess pattern. Fright palpitations can be classified heart deficiency with timidity, heart blood and qi deficiency, heart qi deficiency, heart blood deficiency, heart qi movement stagnation, water qi intimidating the heart, phlegm-fire harassing the heart, phlegm clouding the pericardium, and so on. Palpitations can be classified heart blood deficiency, heart yin deficiency, heart deficiency with timidity, heart spleen blood deficiency, spleen qi deficiency, phlegm-fire harassing the heart, intense heart fire, and so on. Forgetfulness can be classified heart spleen blood deficiency, heart spleen qi deficiency, kidney essence deficiency, heart qi deficiency, non-interaction between the heart and kidney, etc. for deficiency pattern, phlegm clouding the pericardium for excess pattern. In Blood just say inside bleeding pattern's category, there are nose bleeding, flopping syncope, qi counterflow, blood vomiting, hemoptysis, spitting of blood, bloody stool, hematuria, and so on. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.