• 기본간호학회지
• /
• 제5권1호
• /
• pp.125-141
• /
• 1998

The purpose of this research is to analyze the effects of aerobic exercise on body composition, cardiopulmonary function, serum lipid level and antioxidants of obese and normal college female students. The subject group was made up of 13 normal students (below 30% body fat ratio) and 12 obese students (above 30% body fat ratio). After a pretest, the subjects were given an 8-week aerobic program. Then the subjects were given a posttest and analyzed of body composition, serum lipid level, antioxidants and cardiopulmonary function after the 6th and the 8th week of the program. The program schedule was made up of 4 days per week, 60 minutes per day. Test includes B.W., subscapular and triceps subcutaneous fat thickness, change of respiratory gas, and two blood sampling before treadmill exercise and post all out state, which analyzed serum lipid and antioxidants. The subjects performed treadmill exercise starting with 4km/hr of walking and then gradually increase the speed of 1km/hr per minute until all out state. The obtained data were analyzed using SAS program. The statistical methods employed here were one-way ANOVA with repeated measure, Duncan Multiple range test, paired-t test and t-test. The test results and conclusion of this research were as follows. 1. The effects of aerobic exercise on body composition were as follows ; Percent body fat was significantly reduced 6 weeks after the program and lean body mass was significantly increased 8 weeks after the program in both groups(obese group: F=3.44 P=.044, normal group: F=3.30 P=.048). subscapular skinfold of the obese group showed a remarkable decrease after the 6th week(F=4.33 P=.021) triceps skinfold of the normal group showed a remarkable decrease after the 6th and the 8th week(F=4.55 P=.017) compared with readings before the aerobic program, the aerobic program made a bigger difference concerning body fat, lean body mass, subscapular skinfold in the obese group than in the normal group(t=2.41 P=.024, t=2.40 p=.025, t=2.43 p=.028). 2. The effects of aerobic exercise on cardiopulmonary function were as follows ; Maximal $O_2$ uptake/kg was significantly increased 6 weeks after the program in the obese group(F=3.20 P=.054), but not much difference was observed in the normal group. Maximal pulse rate was significantly reduced in both groups after 6 weeks of the program(obese group: F=2.77 P=.087, normal group: F=7.17 P=.001). 3. The effects of aerobic exercise on serum lipid level were as follows ; In a resting period, total cholesterol, Triglyceride, and LDL-cholesterol were slightly higher in the obese group than in the normal group, but HDL-cholesterol was higher in the normal group. But, with the aerobic program, total-cholesterol, Triglyceride, LDL-cholesterol were reduced gradually and HDL-choleterol got increased in both groups, but not much change was noticed in the normal group. However, in the obese group, serum HDL-cholesterol level got increased significantly(F=5.12 P=.012). 4. The effects of aerobic exercise in serum antioxidants were as follows ; In a resting period, the obese group's serum Free Radical and GSSG content were higher than the normal group's and the normal group's serum GSH content was higher than the obese group's. After 6 weeks of the aerobic program, Free Radical was reduced significantly in both groups(obese group: F=13.87 P=.000, normal group: F=18.60 P=.000) In the obese group, 8 weeks after the program, GSH was increased significantly(F=13.78, P=.000). In the normal group, 6 weeks after the program, GSH was reduced but increased again after 8 weeks(F=6.07 P=.005). Plasma GSSG was significantly increased after 8 weeks of exercise in both groups(obese group: F=19.75 P=.000, normal group: F=22.42 P=.000,) Compared with readings before the aerobic program, the aerobic program made a bigger difference serum GSH in the normal group than in the obese group(t=3.37 p=.003). As this result shows, it is known that the regular aerobic exercise improves cardiopulmonary function, body composition, serum lipid effectively and through the serum Free Radical reduction and antioxidant system activation, oxidant stress was suppressed. This effect was higher in the obese group than in the normal one. At least 6weeks exercise period need for improvement of body composition, cardiopulmonary function and activation of antioxidant system. This result suggest that improvement of serum lipid profile was needed longer than 8weeks exercise period.

• Journal of Chest Surgery
• /
• 제36권7호
• /
• pp.531-534
• /
• 2003

5년 전 침윤기태(invasive mole)로 진단받았던 43세 여자가 심폐 바이패스 하에 응급 폐색전 제거술을 시행 받았다. 우측 주폐동맥뿐 아니라 좌하엽 폐동맥에도 종양이 침범되어 완전절제는 얻을 수 없었다. 종양 조직검사에서 융모막 암종으로 확진된 후 환자는 6개월 동안 항암치료를 받았고 완전관해 되었다. 드물지만 가임기 여성에서 폐색전이 있을 때 감별진단으로 융모막 암종을 고려해야 한다.

• Journal of Chest Surgery
• /
• 제21권5호
• /
• pp.911-917
• /
• 1988

Pulmonary thromboembolism originated most commonly from the venous thrombus, especially deep vein thrombus in the leg, which migrated to and occluded the pulmonary vasculatures. The failure of clot lysis and repeated embolic episodes resulted in the hemodynamic compromise -that is- in the increasing in the pulmonary vascular resistance, which would cause the right ventricle failure[Car Pulmonale]. Under the cardiopulmonary bypass, 20 year old male patient was treated successfully by thromboembolectomy of pulmonary thromboembolism with pulmonary hypertension, which originated from the deep vein thrombus in the leg. The results of radiologic studies and clinical evaluations were excellent in that the postoperative lung perfusion scan showed the newly increased perfusion of post-embolectomy territories and in the arterial blood gas finding of 76 from 66[mmHg] in PaO2. The patient was uneventful and discharged on postop. $ 14 days with anticoagulant continued.

• Journal of Chest Surgery
• /
• 제11권2호
• /
• pp.175-180
• /
• 1978

A rare form of tetralogy of Fallot, in which large ventricular septal defect was located at subpulmonary position rather than beneath a well developed crista supraventricularis was operated in this Department. This case satisfied the criteria for the diagnosis of tetralogy of Fallot, having large ventricular septal defect beneath the aortic valve with overriding of aorta, pulmonary stenosis and right ventricular hypeFtrophy. The operation was done through a median sternotomy using cardiopulmonary bypass. A vertical right ventriculotomy was extended to the pulmonary valve ring. Pulmonary and aortic valve were adjacent to each other, in contrast to the situation of classic tetralogy of Fallot. Pulmonary valvulotomy was done and ventricular septal defect was closed. with Teflon, and right ventricular outflow tract was reconstructed with woven Dacron covered by pericardial patch after minimal resection of septal band. The post-operatiove courses was uneventful except wound infection. The patient was discharged 15 days after open heart surgery.

• Journal of Chest Surgery
• /
• 제11권2호
• /
• pp.161-164
• /
• 1978

We operated three cases of intrahepatic inferior vena caval obstruction from January, 1969 to February, 1978 at the department of Thoracic and Cardiovascular Surgery in Seoul National University Hospital. They were all female. And their ages were 33, 38 and 32 respectively. The lesions were the same site; just above the opening of the hepatic vein of inferior vena cava. In first case, segmental narrowing of the inferior vena cava without thrombosis was noted. In second case; thrombus occluded the inferior vena cava and left hepatic vein. In third case, we observed membrane of 4mm thickness which occluded the lumen completely. They were totally operated by using cardiopulmonary bypass. Their post-operative courses were good in the last two cases and re-obstruction was suspected in the first case.

• Journal of Chest Surgery
• /
• 제28권6호
• /
• pp.610-618
• /
• 1995

Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

• Journal of Chest Surgery
• /
• 제29권2호
• /
• pp.213-218
• /
• 1996

Total anomalous pulmonary venous return (TAPVR) is very rare congenital heart disease. 25-year old male was admitted our hospital with dyspnea, headache and syncope as chief complaint. He was confirmed as mixed type TAPVR by echocardiography and cardiac catheterization. In this case, mixed type TAPVR was consisted with supracardiac type connection of left pulmonary vein and cardiac type of right pulmonary vein. Supracardiac type of left pulmonary common channel was anastomosed to the left auricular appendage during total cardiopulmonary bypass with fibrillating heart. Cardiac type of right pulmonary vein was operated during moderate hypothermia and aortic cross clamping. Coronary sinus septum was incised into ASD and closed with Gore-Tex patch so that right pulmonary blood flow directed to the left atrium. The patient's post-operative course was uneventful.

• Journal of Chest Surgery
• /
• 제21권4호
• /
• pp.613-618
• /
• 1988

The exposure of blood to foreign materials can cause the denaturation of plasma protein components such as immunoglobulins and complements. And those phenomena increase the morbidity and mortality after intracardiac operations through the cardiopulmonary bypass. From April, 1987 to September, 1987, we had observed the serial changes of plasma total protein IgG, IgA, IgM, complements[C3, C4] in bubble oxygenator group[n=5] and membrane oxygenator group[n=5]. Statistically significant difference between two groups were present in total protein and C3. We conclude that using membrane oxygenator in long extracorporeal circulation can reduce the activation of alternative pathway of complement system, and which can reduce post-perfusion complications of the lung though we can`t prove it in mass populations.

• 고신대학교 의과대학 학술지
• /
• 제33권2호
• /
• pp.215-222
• /
• 2018

An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.

• Journal of Chest Surgery
• /
• 제10권2호
• /
• pp.299-314
• /
• 1977

Clinical experience on 16 cases of open heart surgery under the extracorporeal circulation with mild or moderate hypothermia and partial hemodilution technique at the National Medical Center during the period from June 1976 to October 1977. Nine of sixteen were congenital heart disease and seven were acquired heart disease. The age of the patient ranged between 6 and 48 years. The body weight varied from 18.5kg to 60kg and body surface area 0. 79-1.70m2. The average priming volume of pump oxygenator was 2080 ml, which was consisted fresh ACD blood, buffered Hartmann`s solution, Mannitol, 50% dextrose in water and Vit. C. The average hemodilution rate was 27%. The average flow 2.3 L/min/m2 or 80 ml/min and the duration of perfusion varied from 31 min to 270 min with average of 107 min. The perfusion was carried out under the mild or moderate hypothermia using core cooling alone in 10 cases, core cooling and local myocardial cooling with $0-4^{\circ}C$ physiologic saline in 2 cases. From a hemodynamic point of view, the blood pressure dropped down around 80 mmHg after the initiation of perfusion follwed by increase to safety level and stable during the perfusion. The central venous pressure remained within normal limits. In most cases, hemoglobin and hematocrit decreased during and after the perfusion. Hemogiobin level was decreased, average of 20.6 %, hematocrit 18.6%, pletelets 55% postoperatively. Plasma hemoglobin increased moderately, from preperfusion average valve of 7.79 mg % to post-perfusion value of 54.7 mg %. Electrolytes changes during cardiopulmonary bypass showed definite hypokalemia but changes of Na, Ca were not definite. Arterial blood gas analysis during cardiopulmonary bypass suggested that the metabolic acidosis which was accompanied by respiratory alkalosis which was corrected postoperatively. As the opera tive complication, transient hemoglobinuria in 4 cases and neurological signs in 2 cases were all cured. There were 2 death cases and operative mortality rate was 12.5%.