• Journal of Chest Surgery
• /
• 제35권6호
• /
• pp.475-478
• /
• 2002

42세 남자환자가 내원 3개월전부터의 호흡곤란, 복부팽만 및 식욕부진으로 내원하였다. 이학적 검사상 심잡음이 청진되어 심초음파를 시행한 결과, 좌심방 혈전을 동반한 승모판협착증 및 삼첨판폐쇄부전이 진단되어 수술전 헤파린 지속 주입을 시작하였다. 내원 11일째 혈소판수치가 감소하여 시행한 항체검사 및 혈소판응괴능 검사에서 음성이 나왔지만 임상적으로 헤파린 기인성 혈소판감소증을 진단하였다. 수술중 심폐우회술시 헤파린 대체약물인 히루딘(hirudin)을 사용하였으며, ACT, aPTT를 측정하며 수술대에서 육안적으로 혈전형성여부를 확인함으로써 성공적으로 수술을 하였다, 수술 중 및 수술 후 헤파린 접촉은 없었으며, 수술 후 과다 출혈 및 전신적 혈전색전증 등의 합병증은 발생하지 않았다.

• Journal of Chest Surgery
• /
• 제27권6호
• /
• pp.427-434
• /
• 1994

A clinical study was designed to evaluate myocardial metabolism during continuous cold blood cardioplegia [Group A, n=10] in comparison with continuous warm blood cardioplegia [Group B, n=10], in a prospective randomized manner. Myocardial metabolism was assessed in two ways: either by collecting blood from coronary sinus before and after cardiopulmonary bypass or by collecting blood from cardioplegic affluent and effluent simultaneously at the beginning and at the end of cardioplegia. The former samples were assayed for gas analysis, lactic acid and cardiac enzyme [CK, LDH, SGOT] and the latter for gas analysis and lactic acid as a maker of anaerobic metabolism. The results were as follows. 1] Myocardial metabolism was shown to be continued in the state of cardioplegia at lower temperature as evidenced by high oxygen extraction of cardioplegic solution in Group A. 2] Anaerobic metabolism occurring at lower temperature in spite of continuous cold blood cardioplegia can be significantly reduced by continuous perfusion of normothermic blood cardioplegics as evidenced by significant reduction of lactate production in Group B [p〈0.05]. 3] Better myocardial protection can be achieved by employing continuous warm blood cardioplegia as evidenced by less cardiac enzyme release in Group B after cardiopulmonary bypass.

• Journal of Chest Surgery
• /
• 제45권5호
• /
• pp.334-337
• /
• 2012

Since the advent of percutaneous cardiopulmonary support (PCPS), its application has been extended to massively injured patient. Cardiac injury following blunt chest trauma brings out high mortality and morbidity. In our cases, patients had high injury severity score by blunt trauma and presented sudden hemodynamic collapse in emergency room. We quickly detected cardiac tamponade by focused assessment with sonography for trauma and implemented PCPS. As PCPS established, their vital sign restored and then, they were transferred to the operation room (OR) securely. After all injured lesion repaired, PCPS weaned successfully in OR. They were discharged without complication on day 26 and 55, retrospectively.

• Journal of Chest Surgery
• /
• 제47권3호
• /
• pp.298-301
• /
• 2014

A 35-year-old man was admitted to Korea University Anam Hospital for evaluation of intermittent chest pain. Computed tomography of the chest showed enlargement of a previously identified anterior mediastinal mass and also a well-defined, circumscribed mass in the subcarinal area, surrounded by the roof of the left atrium, right pulmonary artery, and the carina. Complete resection of the intrapericardial tumor was performed through median sternotomy without cardiopulmonary bypass. Pathologic examination identified the tumor as schwannoma, of an ancient type, diffusely positive for the S-100 antigen. Unlike other reported cases, grossly, the tumor did not seem to be involved with any nerve.

• 대한물리의학회지
• /
• 제5권2호
• /
• pp.255-264
• /
• 2010

Purpose : The purpose of this study is to analysis effects of resistive exercise on cardiopulmonary fitness and cerebral artery blood flow velocity. Methods : Ten healthy university students had done resistive exercise without aerobic exercise over one year participated resistive exercise group and ten general university students, then were calculated oxygen consumption ($VO_2$) and respiratory exchange rate($VO_2/VCO_2$). After a week, they were measured Transcranial Doppler Ultrasonography(TCD) at moderate exercise(HRmax 50%), maximal exercise (HRmax 100%) for taking cerebral blood flow velocity. Results : In the comparison between groups, resistive exercise group showed significant higher oxygen consumption and lower respiratory exchange than controls(p<0.05). In resistive exercise group, oxygen consumption was significant negative correlation with cerebral artery pulsatory index(p<0.05). but, oxygen consumption was significant positive correlation with systolic blood flow velocity in controls(p<0.05). Conclusions : After considering all the factors, important value in resistive exercise is regular participation and help us increasing contingency response ability.

• 한국응급구조학회지
• /
• 제19권3호
• /
• pp.139-148
• /
• 2015

Purpose: This study aimed to compare the chest compression quality between compression-only cardiopulmonary resuscitation (CPR) and conventional CPR. Methods: This study involved 123 participants randomly assigned to either the chest compression-only CPR training and conventional CPR training. After training for 120 min, the participants performed CPR for 4 min and the CPR quality was evaluated. The primary outcome was evaluated as the mean compression depth, and the secondary outcome was calculated as the proportion of chest compressions with an appropriate depth among the total chest compressions. Results: The mean compression depth was more deeper in conventional CPR than in compression-only CPR (57mm vs. 53mm, p <.001). The proportion of appropriate chest compression depth was also more higher in conventional CPR (98.8% vs. 68.6%, p <.001). As compared with every minute over time for a total of 4 min, the mean compression depth and the proportion of appropriate chest compression depth were deeper and higher after 1 min in conventional CPR than in compression-only CPR. Conclusion: The results suggested that conventional CPR is a better method than compression-only CPR in terms of chest compression quality.

• Journal of Yeungnam Medical Science
• /
• 제31권2호
• /
• pp.122-126
• /
• 2014

Coronary vasospasm is one of the fatal complications that may occur in patients undergoing open heart surgery. To date, however, there are not many cases in this series and no definite pathophysiology has been documented. We experienced a case of coronary artery vasospasm after atrial septal defect (ASD) surgery and then successfully treated it with both transbrachial intraaortic balloon pump and percutaneous cardiopulmonary support. Only several hours after ASD surgery, the patient exhibited the cardiovascular collapse, the ST-segment elevation, followed by ventricular fibrillation and normal coronary angiography findings. It is important to make a differential diagnosis of coronary artery vasospasm in patients presenting with ST-segment elevation who had no notable coronary artery diseases. This case indicates that clinicians should be aware of the possibility that the coronary artery vasospasm may also occur in patients undergoing ASD surgery.

• 한국임상수의학회지
• /
• 제35권1호
• /
• pp.10-12
• /
• 2018

Mitral regurgitation is the most frequent cause of cardiac disability and death in dogs. A wide range of medical and surgical treatments have been used for mitral regurgitation. Surgical treatments for complete correction of mitral regurgitation include valve repair and valve replacement, which have the advantages of eliminating or correcting the primary cause. Surgical treatments approach the mitral valve via right- or left-side thoracotomy. Aortic root exposure is needed for cardiopulmonary bypass. To compare right-side and left-side approaches, 10 dog cadavers were used in this study. Subsequently, the left-side surgical approach was used in vivo and in conjunction with cardiopulmonary bypass and cardioplegic arrest. Based on the results, and considering ease of access to the aortic root, valve incision site, and visualization of the surgical field, a left-side approach is recommended.

• 대한물리의학회지
• /
• 제18권1호
• /
• pp.51-57
• /
• 2023

PURPOSE: Recently, the proportion of respiratory diseases has been increasing worldwide, and deaths from respiratory diseases in Korea are increasing. Maintaining a healthy respiratory function is a crucial factor in preventing respiratory diseases. There are various ways to improve respiratory function, such as respiratory muscle and aerobic exercises. In other countries, respiratory muscle exercise is performed using a respiratory resistance mask, but such research is insufficient in Korea. Therefore, this paper proposes a respiratory exercise program using a respiratory resistance mask. METHODS: This study was conducted by dividing healthy adults in their 20s into a treadmill exercise + respiratory resistance mask group and a treadmill exercise group into an experimental group and a control group. The changes in the subject's physical function before and after exercise were confirmed by cardiopulmonary exercise and pulmonary function tests. RESULTS: As a result of the study, the experimental and control groups increased their physical function significantly (p < .05). On the other hand, when the increase rate according to the group was confirmed, the increase rate of the experimental group was higher. CONCLUSION: Based on this study, it is necessary to develop a respiratory exercise program using respiratory exercise tools such as a respiratory resistance mask and provide it easily to various subjects.

• Journal of Veterinary Science
• /
• 제24권3호
• /
• pp.47.1-47.7
• /
• 2023

Del-Nido cardioplegia (DNc) is a single-dose cardioplegia that is widely used in human medicine because of its long duration. In this report, we describe two cases of open-heart surgery with cardiopulmonary bypass (CPB) using DNc. One dog was diagnosed with partial atrioventricular septal defect, and the other dog was diagnosed with myxomatous mitral valve disease stage D. Both dogs were treated with open-heart surgery with DNc to induce temporary cardiac arrest. No complications from DNc were observed, and the patients were discharged. Veterinary heart surgeons should consider DNc as an option for temporary cardiac arrest during open-heart surgery with CPB.