• Title/Summary/Keyword: 심부전

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A clinical case study of a shaoyangin patient diagnosed as congestive heart failure (울혈성 심부전으로 진단받은 소양인 환자 치험 1례)

  • Kim, Kyung-Seon;Lim, Eun-Chul;Ko, Woo-Seog
    • Journal of Sasang Constitutional Medicine
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    • v.14 no.3
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    • pp.160-166
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    • 2002
  • A clinical case study of a shaoyangin patient diagnosed as congestive heart failure Congestive heart failure is dysfunction of heart that can't supply sufficient mount of blood required of tissue metabolism as a result of myocardial hyposystole. We treated 80 year-old female congestive heart failure patient with edema, dyspnea, chest discomfort, and dysuria. We have diagnosed her as shaoyangin(少陽人) pyohan(表寒) disease, infirmity, edema and have prescribed hyungbangjihwangtang(荊防地黃湯). In the result we had the improvement of the symptoms of CHF and general depressed condition. This report described the process and contents about the way the patient was cured.

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Development of the Efficiency-Evaluation Model for the Mechanism of CO2 Sequestration in a Deep Saline Aquifer (심부 대염수층 CO2 격리 메커니즘에 관한 효율성 평가 모델 개발)

  • Kim, Jung-Gyun;Lee, Young-Soo;Lee, Jeong-Hwan
    • Journal of the Korean Institute of Gas
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    • v.16 no.6
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    • pp.55-66
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    • 2012
  • The practical way to minimize the greenhouse gas is to reduce the emission of carbon dioxide. For this reason, CCS(Carbon Capture and Storage) technology, which could reduce carbon dioxide emission, has risen as a realistic alternative in recent years. In addition, the researcher is recently working into ways of applying CCS technologies with deep saline aquifer. In this study, the evaluation model on the feasibility of $CO_2$ sequestration in the deep saline aquifer using ANN(Artificial Neural Network) was developed. In order to develop the efficiency-evaluation model, basic model was created in the deep saline aquifer and sensitivity analysis was performed for the aquifer characteristics by utilizing the commercial simulator of GEM. Based on the sensitivity analysis, the factors and ranges affecting $CO_2$ sequestration in the deep saline aquifer were chosen. The result from ANN training scenario were confirmed $CO_2$ sequestration by solubility trapping and residual trapping mechanism. The result from ANN model evaluation indicated there is the increase of correlation coefficient up to 0.99. It has been confirmed that the developed model can be utilized in feasibility of $CO_2$ sequestration at deep saline aquifer.

Clinical Experience of the Surgical Treatment of Cardiac Tumor (심장 종양의 수술적인 치료의 임상적 고찰)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Cho, Gwang-Jo;Kim, Si-Ho;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.375-380
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    • 2010
  • Background: Primary cardiac tumors are extremely rare. The most common type are benign myxomas, and these are almost completely curable with early surgery. Malignant tumors, however, such as sarcomas, are difficult to remove surgically, and their prognosis is known to be poor. In this study, data on patients who had undergone surgical treatment of cardiac tumor in the authors' hospital were collected and analyzed. Material and Method: The subjects included 28 patients who had undergone surgical treatment of cardiac tumor from August 1993 to December 2008. Their medical records were reviewed and retrospectively analyzed. Result: The patients were aged from 20 to 76 years (mean age: $54.2{\pm}15.6$), and 11 were male (39%) and 17 female (61%). Fifteen of them (54%) underwent emergency surgery to improve heart failure symptoms. The most common preoperative symptom was dyspnea (15 cases, 54%). Preoperative echocardiography was performed on all the patients. The average size of the tumor as measured during the operation was $7.0{\pm}6.9cm$ (the average length of the long axis was 2∼40 cm), and the sites of tumor attachment were the interatrial septum (18 cases, 64%), the left atrium (9 cases, 32%), the mitral valve annulus (2 cases, 7%), and the left ventricle (2 cases, 7%). The operation was performed with an incision through both atria in all the patients, and a complete excision was made in 25 cases (89%). According to the biopsy results, there were 4 cases of sarcoma (14%), 1 case of lipoma (4%), and 23 cases of myxoma (82%). The three cases in which the tumors were not completely excised were sarcomas. No operative deaths occurred after the operations. Outpatient follow-up was possible for 24 cases (86%), with a mean follow-up period of $46.8{\pm}42.7$ months. Late death occurred in 3 of the 24 patients; each of these patients had sarcomas. Of these patients, the first had undergone two repeat surgeries, the second had metastatic sites removed, and the last had only chemotherapy. The average recurrence time was $12.7{\pm}10.8$ months, and the average metastasis time was $20.5{\pm}16.8$ months. Conclusion: Most cardiac tumors are benign myxomas. In principle, they should be surgically treated because they can create risks such as embolism, and can be radically treated when surgically removed. In most cases, however, malignant sarcomas are already considerably advanced with severe infiltration into the neighboring tissues at the time of diagnosis. The surgical removal of malignant sarcomas is known to be difficult because of the advanced stage and degree of infiltration. We suggest that excision of the removable portion of the tumor sites to alleviate symptoms such as heart failure can improve quality of life.

Studies for B-type Natriuretic Peptide Values and Its Association with Diastolic Echocardiographic Parameters (B-type Natriuretic Peptide 수치와 이완기 심초음파 파라미터와의 연관성 연구)

  • Bae, Seong-Jo;Kwon, Kisang;Lee, Eun Ryeong
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.394-400
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    • 2016
  • The b-type natriuretic peptide (BNP) values and increase on functional disorder in the ventricle, and are used as an index to diagnose heart failure and predict the prognosis. BNP values is known to be relevant to dyssystole in congestive heart failure. This study aimed to identify correlation between the BNP values and the items that indicate the diastolic function in echocardiography. The research divided 188 patients who went through the BNP test and echocardiography in the hospital into the groups with the BNP values; <100, 100-300, 301-600, 601-900, and >901 pg/mL. As the BNP values increase, there was relevance with the echocardiography items of ejection fraction, size of left atrium, E velocity, A velocity, Deceleration time, E/A ratio, E', A', S' and E/E'. In comparison on the groups divided based on the BNP values, E/E' had the highest relevance. The research also categorized 67 patients who diagnosed with heart failure. In comparison on the groups of the heart failure patients, the BNP values of the three groups of Grade I: $623.0{\pm}459.7pg/mL$, Grade II: $1013.2{\pm}1155.1pg/mL$ and Grade III: $1693.4{\pm}1544.0pg/mL$, respectively (p<0.01). As the grade was higher, there was a higher relevance with the echocardiography items of ejection fraction, size of left atrium, E velocity, A velocity, Deceleration time, E/A ratio, E', A', S' and E/E' (p<0.001). Higher BNP values had a higher relevance with the items that indicate the diastolic function in echocardiography and the BNP values of the Restrictive physiology group were the highest in echocardiography. So the BNP values was thought to be valuable to predict diastolic function of heart.

Analysis of Surgical Risk Factors in Pulmonary (폐국균종의 수술위험인자 분석)

  • 김용희;이은상;박승일;김동관;김현조;정종필;손광현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.281-286
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    • 1999
  • Background: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. Material and Method: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6${\pm}$11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. Result: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). Conclusion: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.

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Effects of Lumbar Stabilization Exercise using PNF Techniques on Thickness of Lumbar Deep Muscle and Functional Activity in Chronic Low Back Pain Patients (만성요통환자에서 PNF 기법을 이용한 요부안정화 운동이 요부 심부근 두께 및 기능적 활동에 미치는 효과)

  • Kim, Gi-Do;Lee, Yun-Jung;Choi, Wan-Suk;Lee, Dong-Woo;Jung, Dae-In;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.3
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    • pp.233-243
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    • 2012
  • The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.

Open Heart Surgery of Ventricular Septal Defect in Infancy (영아기 심실중격결손의 개심술)

  • 조준용;허동명
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.271-277
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    • 1996
  • In selected cases, early corrective surgery is indicated in the management of infants having large ventricular septal defects. The risk of any surgical procedure in infancy is acknowledged to be great and should be avoided whenever possible. However this greater surgical risk is justified when the patient presents with intractable congestive heart failure, severe pulmonary hypertension, marked growth retardation, and recurrent prolonged lower respiratory infections. We analyzed 31 patients with ventricular septal defect in infancy who underwent surgical correction from January 1991 through December 1994. Age ranged from 6 months to 12 months with mean age of 9.2 months. Of the thirty-one patients, 23 patients were male and 8 patients were female. Mean body weight was 7. 4kg. The most common type of ventricular septal defect was perimembraneo s (64.5%). Associated cardiac anomalies were found in 17 patients (55.8%). Mitral regurgitation was the most commonly associated cardiac anomaly (16.1 %) and followed by patent ductus arteriosus (12.9%). When cardiac catheterization data were analysed, the most common range of Qp/qs, RpiRs, Pp/ps were 2.1∼ 3.0, 1-0.25, above 0.70 respectively. Among the indications of surgical correction, there were pulmonary hypertension in 20 patients, congestive heart failure in 3 patients, intractable respiratory infection in 10 patients and growth retardation in 14 patients. The most common surgical approach and method for closure of ventricular septal defect .were right atriotomy (58%) and Dacron patch closure (94%). Postoperative complications occurred in 10 cases (32%) and overall mortality was 12.9% (4 cases). All operative deaths in this series occurred in infants under the age of 8 months and weight of 8 kilograms.

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Effects of spinal stabilization training on Chronic Low Back Pain in Private Guard and Security (척추안정화 운동이 민간 경호.경비원들의 허리통증에 미치는 영향)

  • Kim, Seong-Ho;Lee, Wan-Hee
    • Korean Security Journal
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    • no.20
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    • pp.71-93
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    • 2009
  • The purpose of this study was to evaluate the effects of using spinal stabilization exercise for the improvement of atrophy of the multifidus and psoas major, of pain and disability with chronic low back pain in private guard and security. For 42 patients diagnosed with CLBP, and divided into spinal stabilization exercise group(SSEG) and general spinal strengthening exercise group(GSSEG). Each exercise was conducted for 10 weeks. Pain and disability were measured before and after exercise using the Visual analogue scale(VAS) and the Oswestry disability index(ODI). Cross section area(CSA) of both the left and right multifidus and the psoas major at the upper end plate of L4 were measured before and after exercise using computed tomography(CT). After 10 weeks of exercise, the both group's pain and lumbar disability were significantly decreased(p<0.01). Also there was significant difference in both group(p<0.05). In addition, the CSA of the left and right multifidus and posas major were significantly increased as compared to the pre-exercise in both group(p<0.01). But SSEG's cross sectional areas of multifidus was more significantly increase than GSSEG(p<0.05). In summary, Spinal stabilization exercise is more effective in improving atrophy in private guard and security patients, in reducing patients' pain and disability. It is an effective treatment to aid rehabilitation in these cases.

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Surgical Result of Congenital Mitral Regurgitation in Children (선천성 승모판폐쇄부전증 교정수술의 단기성적)

  • 홍유선;박영환
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.373-377
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    • 1997
  • Between January, 1991 and May 1995, mitral valve repair was undertaken on 32 patients under 15 years for congenital mitral regurgitation. Mean age was 24.0$\pm$26.1 months(range 3 months to 15 years), 16 patients were male and 16 patients were female associated cardiac anomalies were found in 26 patients (81%), and ventricular septal defects were noted in 18 patients(56%). In regards to pathologic findings, there were annular dilatation(n:7), leaflet prolapse(n=18), cleft leaflet(n=5) and restricted valve motion (n=2). The method of repair consisted of annuloplasty(Modif ed Devega type) in 14, repair of redundunt leaflet in 6, closure of cleft in 5, triangular resection in 2 and splitting of papillary muscle in one. There was no operative mortality and two late deaths occurred as a result of heart failure and sepsis. Tro patients required replacement of the mitral valve after 3 months and 7 months respectivehy because of recurrent mitral regurgitation. Actuarial survival was 92.5% at 46 months and actuarial freedom from reoperation was 95% at 12 months and 92.5% at 46 months. Actuarial freedom from valve repair failure was 68% at 12 months and 61.8% at 46 months. Although valve repair failure rate was high, we believe that mitral valve repair should be of rcrred to children because of low mortality and low reoperation rate.

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Matrix Metalloproteinase-1 and Tissue Inhibitor of Metalloproteinase-1 levels in Exudative Pleural Effusions (삼출성 흉수에서 기질 금속단백분해효소-1과 금속단백분해효소의 조직억제제-1)

  • Cho, Jae Hwa;Nam, Jeong Hyeon;Lee, Kyum Ho;Yoon, Byeong Kab;Ryu, Jeong Sun;Kwak, Sung Min;Lee, Hong Lyeol
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.517-521
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    • 2005
  • Background : The balances of the proteinases and antiproteinases system have been implicated in the pathogenesis of various exudative pleural effusions. The aim of this study was to examine the matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in exudative pleural effusions. Methods : The study included 33 tuberculous effusions, 17 malignant, and 5 transudates. The pleural levels of MMP-1 and TIMP-1 were determined using a commercially available ELISA assay. Results : The group of tuberculous effusions showed higher pleural MMP-1 levels than the malignant and transudates. The pleural TIMP-1 levels of the tuberculous and malignant effusions were higher than the transudates. Conclusion : Elevated pleural MMP-1 and TIMP-1 levels were found in tuberculous effusions.