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Repair of a Post-infarction Ventricular Septal Defect and Left Ventricular Pseudoaneurysm Rupture by the "Sandwich Technique" - A case report - ("Sandwich Technique"을 이용한 심근경색 후 발생한 심실 중격 결손과 가성 좌심실류 파열의 수술 - 1예 보고 -)

  • Kim, Hyung-Tae;Kim, Wook-Sung;Park, Pyo-Won;Lee, Young-Tak;Sung, Ki-Ick;Lee, Mi-Na
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.516-519
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    • 2009
  • Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

A Clinical Study about the Effects of Soshiho-tang on a Case of Parkinson's Disease with Pontine Infarction. (뇌교경색을 동반한 파킨슨병 환자의 소시호탕(小柴胡湯) 치험예)

  • Yang, Jae-Chul;Kim, Sung-Keun;Lee, Kyung-Yun;Kim, Ju-Young;Koo, Beom-Mo
    • The Journal of Korean Medicine
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    • v.28 no.2 s.70
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    • pp.34-43
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    • 2007
  • Objective : The purpose of this study is to report improvement after application of herbal medicine (Soshiho-tang) treatment to a patient who has Parkinson's disease with pontine infarction. Methods : We treated the patient with acupuncture and herbal medication (Soshiho-tang). Results : We have experienced one case of patient who has Parkinson's disease with pontine infarction. This case improved significantly through herbal medication (Soshiho-tang) treatment. Conclusions : This study suggests herbal medication (Soshiho-tang) is effective for the improvement of the symptoms of a patient's who has Parkinson's disease with pontine infarction.

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Left Ventricular Systolic Function Improvement after Surgical Revascularization in Postinfarction Angina (급성 심근 경색 후 협심증 환자에서의 관상동맥 우회술 후 좌심실 수축 기능의 호전)

  • Yi Gi-Jong;Park Seong-Yong;Hong You-Sun;Yoo Kyung-Jong;Chang Byung-Chul;Lim Sang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.674-680
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    • 2006
  • Background: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who under-went surgical revascularization under diagnosis of acute MI. Material and Method: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. Result: WMSI decreased from $1.54{\pm}4.30\;to\;1.43{\pm}0.40$ (p<0.001) and LVEF increased from $48.1{\pm}12.2%\;to\;49.7{\pm}12.3%$ after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p=0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). Conclusion: Coronary artery by-pass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.

Aortic Thrombus with Myocardial Infarction - 2 case reports - (심근 경색후 발생한 대동맥내 혈전 - 치험 2예 -)

  • Yun, Chi-Hyeong;Oh, Sang-Gi;Kim, Soon-Jin;Jeong, In-Seok;Ahn, Byoung-Hee;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.300-303
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    • 2010
  • A thrombus in the aorta is a rare condition that is generally detected after cerebral, visceral or peripheral emboli. We reported here on two cases of aortic thrombus with myocardial infarction.

Clinical Significance of Creatine Kinase MB mass and Cardiac Troponin I as a Marker of Perioperative Myocardial Infarction After Coronary Artery Bypass Grafting (관상동맥 우회술 후 심근경색의 표지자로서 Creatine Kinase MB 농도와 Cardiac Troponon I의 임상적 의의)

  • 이재진;김응중;이원용;신윤철;지현근
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.27-35
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    • 2002
  • Background: A perioperative myocardial infarction(PMI) is one of the major complications after CABG. Among diagnostic methods of PMI, CK-MB activity assays have been increasingly replaced by CK-MB mass assays, which have more sensitive, simple measurement. Also, new cardiac-specific and -sensitive marker, cardiac troponin I(cTnl), has been shown to be a marker of myocardial infarction. We report our evaluation of clinical significance of CK-MB mass and cTnl as a marker of PMI after CABG. Material and Method: We studied 32 patients who underwent CABG at Kangdong Sacred Hospital between April 2000 and April 2001. Postoperative serum CK-MB activity level, serum CK-MB mass, cTnl, electrocardiogram, echocardiogram, and clinical data were recorded prospectively The diagnosis of PMI was defined as positive 2 among 3 or all of the following , by a new Q wave on the electrocardiogram, by serum CK-MB activity higher than 200 lU/L within 72 hours after operation, and by new regional wall motion abnormality on the echocardiogram. Result: After CABG, 3 patients had sustained a PMI according to current diagnostic criteria. As serum CK-MB activity time course, a level of CK-MB activity 12 hours after CABG had very linear correlated significance with serum CK-MB mass 24hours(R=0.946) and cTnl 48 hours(R=0.933) after CABG(p=0.000). As we used a receiver operating characteristics curve(ROC curve) for a diagnostic cutoff value in patients with PMI, serum CK-MB mass levels higher than 30.05 ug/L 24 hours after CABG detected the presence of PMI with an area under the ROC curve of 1.0, a sensitivity of 100%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 100%. Also serum cTnl levels higher than 17.15 ug/L 48 hours after CABG detected the presence of PMI with an area under the ROC curve of 0.98, a sensitivity of 100%, a specificity of 96.6%, a positive preclictive value of 75%, and a negative predictive value of 100% Conclusion: We concluded that both the measurement of CK-MB mass and cTnl are the easier, accurate methods as a diagnostic marker of PMT after CABG, also as a proposal of diagnostic cutoff value enables to an early detection of PMI. However, a 1arger number of patient will be needed because of statistic limitation that a small number of participating patients, a small number of PMI.