• Title/Summary/Keyword: 심장크기

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Surgical Rrepair of Ebsteins Anomaly with Ventricular Septal Defect in the Infant (영아에서 시행한 심실중격결손이 동반된 Ebsein's 기형의 삼첨판막 성형수술)

  • 유지훈;박표원;성기익;박계현;이영탁;전태국
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.890-893
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    • 2002
  • Ebsteins anomaly is a rare congenital cardiac malformation that is the downward displacement of the septal and posterior leaflets of the tricuspid valve into the ventricular apex, aresulting in the formation of an atrialized portion of the right ventricle. In most patients, symptoms such as cyanosis and progressive heart failure occur during the adolescence or young adulthood. The associated anomalies include ventricular septal defect, transposition of the great arteries, and malformation of the mitral valve. An 8-months-old male with Ebsteins anomaly, ventricular septal defect, and duplication of the mitral valve orifice successfully underwent operation with VSD patch closure. Postoperatively, cardiac size was significantly reduced and tricuspid regurgitation was trivial in echocardiography He has been doing well without any cardiac medication during the 18 months follow up after operation.

Development of Portable Cardiopulmonary Support System (이동형 심폐보조시스템의 개발)

  • Lee, Hyuk-Soo;Min, Byoung-Goo
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.44 no.1
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    • pp.94-99
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    • 2007
  • Many cases of acute cardiac shock and cardiac arrest in emergency room and ICU have been increasing. In this case, ECMO with centrifugal pump has been used generally. However, due to the heavy weight and big size, the system is not adequate for emergency cases. And other defects of this system are that membrane oxygenator's pressure is high and blood are exposed to the air. There was some tries of ECMO using pulsatile pump, but it was found that the weak point of these system is high peak pressure and hemolysis. The mechanism of twin pulsatile pump is that Membrane oxygenator Outlet Pump(MOP) make negative pressure when Membrane oxygenator Inlet Pump(MIP) provides high positive pressure, and the negative pressure will decrease positive pressure of Membrane Oxygenator. Our group analyzed this advantage through In-Vitro and 12 Cases In-Vivo test.

Right Pulmonary Artery Agenesis -A Case Report- (우측 폐동맥 형성부전증 -수술치험 1례-)

  • Sin, Dong-Geun;Kim, Min-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.108-111
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    • 1997
  • Congenital unilateral agenesis of pulmonary artery is a rare anomaly and it usually occurs in association with other cardiac anomaly such as tetralogy of Fallot. Since most patients affected by this defect without associated congenital cardiac anomaly or pulmonary Infection are asymptomatic, the clinical diagnosis of this anomal is first recognized by a characteristic pattern in chest roentgenogram taken as a routine checking; the findings on chest film consists of cardiac and mediastinal displacement, absence of the pulmonary arterial shadow, smaller hemithorax, and elevationof the hemidiaphragm, all on the affected side. We experienced rlght pulmonary artery agenesis in a 48 year-old male, who complained of massive hemoptysis, and it was diagnosed by digital subtraction pulmonary arteriogram and perfusin scan, and treated by right middle and lower lobe bi-lobectomy, and we report this case with the review of relevant literatures.

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Congenital Aortic Valvular Insufficiency Caused by Abnormal Valvular Structures in a Labrador Retriever Dog (래브라도 리트리버종 개의 비정상 판막 구조에 의한 선천성 대동맥 판막 부전)

  • Moon, Hyeong-Sun;Lee, Seung-Gon;Lee, Sang-Eun;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.233-237
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    • 2007
  • A 10-month-old intact male Labrador Retriever dog was referred with the primary complaint of exercise intolerance, especially after vigorous exercise. Physical examination revealed split S1 and grade III/VI diastolic regurgitant murmur at the left apex and base, respectively. ECG finding was normal sinus rhythm at rest, but supraventricular tachycardia with bundle branch blocks after exercise. Thoracic radiography revealed dilated ascending aorta with normal range of cardiac silhouette (VHS 10.2). Echocardiography revealed abnormal valvular structures just above the aortic valvular cusps causing aortic regurgitation with a reduction of left ventricular ejection fraction (LVEF). Based on those findings, the case was diagnosed as congenital aortic regurgitation caused by abnormal valvular structures. The dog was managed with diltiazem and exercise restriction. This is a rare case of aortic deformity in dogs.

The Effect of Antioxidative Change in Cardiac Muscle of Obesity Rat by Treadmill Exercise with Intensity and Time (운동강도와 지속시간에 따른 트레드밀 운동이 비만 쥐의 심장근 내 항산화에 미치는 영향)

  • Kim, Myung-Hee;Kim, Young-Eok;Yoon, Chang-Lyuk;Ryu, Ji-Won;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.35-51
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    • 2013
  • The aims of this study was to observed an effect of antioxidative in cardiac muscle of high fat diet induced obesity rat by treadmill exercise with intensity and time. Thirty-two Sprauge-Dawley rats which were divided into four group. Normal, Control(high fat diet induced obesity rat), Experimental I(high intensity intermittent exercise in high fat diet induced obesity rat), Experimental II(moderate intensity endurance exercise in high fat diet induced obesity rat). The results of this study were as follows: 1. In change of body weight, the outcome of each group significantly difference compared with control. Also, 1 to 3 weeks significantly different compared with pre valu experimental I and II(p<0.001). 2. In change of lipid profile, the outcome of each group significantly difference compared with control(p<0.001). Difference between experimental I and II is not significantly. 3. In change of antioxidative enzymes(SOD, CAT, GPx) in myocardium, there are significant difference between control and experimental II, and also between control and experimental I(p<0.001). 4. In change of antioxidative protein MCR-1, the outcome of each group significantly difference compared with control(p<0.01). Experimental II was most significantly difference than the other group(p<0.001). The above results suggest that treadmill exercise effectively reduced in fat. It would be considered that moderate intensity endurance exercise has an effects on improved antioxidative enzyme in cardiac muscle of high fat diet induced obesity rat.

The Effects of the Expression of GATA Binding Protein 6 on Heart and Brain Development (심장과 뇌 발달에서 GATA6 유전자 발현 감소가 미치는 영향)

  • Seo, Jungwon
    • Journal of Life Science
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    • v.25 no.11
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    • pp.1230-1234
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    • 2015
  • GATA binding protein 6 (GATA6) is a transcription factor that is expressed in the early blastocyst stage and controls the expression of important genes in the differentiation and development of the heart, pancreas, and intestine. This study confirmed the role of GATA6 in cell differentiation and organ development using mouse embryonic stem cells and zebrafish, respectively. First, the mouse embryonic stem cells were differentiated into pacemaker cardiomyocytes. An RT-PCR analysis revealed that the expression of the GATA6 gene was greatly increased from day 4 of differentiation. The expression of GATA6 was upregulated prior to increased expression of NK2 homeobox 5 (Nkx2.5) and myocyte enhancer factor 2C (MEF2C), which are critical transcription factors involved in regulating heart formation. To examine the role of GATA6 in development, GATA6 morpholino was microinjected into zebrafish embryos. Knockdown of GATA6 expression significantly decreased the heart size and heart rate in the zebrafish compared to a control. In addition, the brains were degenerated in the GATA6 morpholino-injected zebrafish. Acridine orange staining showed that knockdown of GATA6 expression increased apoptotic cells in the brain. Interestingly, knockdown of GATA6 expression decreased apoptotic cells in the early bud stage. This study points to the importance of the GATA6 gene in heart and brain development.

Cardioprotective Effect by Preconditioning with Calcium-free Solution (칼슘결핍용액 투여 전처치에 의한 심근보호 효과)

  • 조대윤;이종화;김호덕
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.773-780
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    • 1999
  • Background: It has been demonstrated that brief periods of calcium depletion and repletion (calcium-free preconditioning, CP) have cardioprotective effects as seen in ischemic preconditioning(IP) which enhances the recovery of post-ischemic contractile dysfunction and reduces the incidence of reperfusion-induced arrhythmia or infarct size after a prolonged ischemia. In the present study, we tested this paradoxical phenomenon in isolated rabbit hearts. Material and Method: Hearts isolated from New Zealand white rabbits(1.5∼2.0 Kg body weight) were perfused with Tyrode solution using the Langendorff technique. After stabilizing the baseline hemodynamics, the hearts were subjected to 45 minutes of global ischemia followed by 120 minutes of reperfusion with IP(IP group, n=7) or without IP (ischemic control group, n=7). IP was induced by a single episode of 5 minutes global ischemia and 10 minutes reperfusion. In the CP group(n=7), the hearts were subjected to perfusion with Tyrode solution with calcium depletion for 5 minutes and repletion for 10 minutes, and 45 minutes of ischemia and 120 minutes of reperfusion. Left ventricular function including developed pressure, dP/dt, heart rate, left ventricular end-diastolic pressure and coronary flow was measured. Infarct size was determined by staining with 1% triphenyltetrazolium chloride and planimetry. Data were analyzed by a one-way analysis of variance and Tukey's post-hoc test. Result: In comparison with the ischemic control group, IP significantly enhanced the recovery of the left ventricular function including the left ventricular developed pressure, contractility, and coronary flow; in contrast, these functional parameters of the CP group tended to be lower than those of the ischemic control group. However, the infarct size was significantly reduced by IP or CP(p<0.05). Conclusion: These results suggest that in isolated Langendorff-perfused rabbit heart model, CP(induced by single episode of 5 minutes calcium depletion and 10 minutes repletion) could not improve the post-ischemic contractile dysfunction(after a 45-minute global ischemia) but it has an infarct size-limiting effect.

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The Covering of the Suture Area with an Absorbable Cellulose Mesh and Fibrin Glue in Bullectomy of Primary Spontaneous Pneumothorax (일차성 자연기흉의 수술시 흡수성 셀룰로스 망사 및 Fibrin glue의 도포와 재발에 대한 임상적 고찰)

  • 허동명;김병호
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.393-398
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    • 2001
  • 배경: 일차성 자연기흉의 재발방지를 위해서 폐기포절부위에 흡수성 셀룰로스망사와 Fibrin gluefm 도포하여 수술후 재발율을 줄일 수 있는 지 알아보았다. 대상 및 방법: 1996.4우러부터 2000.6월까지 2명의 술자가 222례의 일차성 자연기흉을 수술하였으며, 수술시기와 치료방법에 따라 4군으로 나누어 비교하였다. 제1군은 1996년부터 1997년가지 비디오흉강경수술 및 기계적 늑막유착술로 시술받은 군(25례), 제 2군은 같은 기간동안 액와개흉술 및 늑막유착술로 시술받은 군(53례), 제 3군은 1998년부터 2000.4월까지 흉강경수술 및 늑만유착술로시술받은 군(110례), 제 4군은 1999.7월부터 2000.6월까지 흉강경수술 및 봉합부위를 셀룰로스망사와 Fibrin glue로 보강한 군(34례)이었다. 각 군간, 엑스선상 기흉의 크기 및 폐기포의 수나 크기에 따라 재발율, 공기누출시간 및 흉관지속지간등을 일반선형모델을 사용하여 비교 분석하였다. 결과: 대상환자는 남자 203례, 여자 19례 이었고, 나이는 14게에서 68세이었고, 평균연령은 23.2$\pm$9.6세였다. 재발한 경우는제 1군이 5례(25%), 제 2군이 2례(3.8%), 제 3군이 5례(4.5%)이었고, 제 4군은 재발례가 없었다. 재발례는 모두 수술자의 수술경험이 2년이내일 때 발생하였다. 흉관지속기간은 제 4군이 제 3군(p<0.0006) 및 제1, 제2군(p<0.0001)에 비해서 더 짧았고, 술후 공기누출이 제 4군에서는 없었다. 술전흉부엑스선상 기흉의 크기에 따른 수술후 기흉의 재발울은 경도의 기흉에서 14.3%(2/14)이었고, 중등도 기흉에서 7.4%(10/134)이었으며, 심한 기흉에서는 재발례가 없었다. 재수술한 12례중 봉합부위근처에서 기포가 발행된 경우가 9례(75%)로 많았다. 결론: 재발방지를 위한 시술로 늑막유착술을 시행하지 않고 폐기포절제부위를 흡수성 셀룰로스망사와 Fibrin glue로 덮어주는 시술은 비교적 용이하며, 수술 후 공기 누출이 없었고, 수술 후 흉관지속기간이 더 짧았고, 단기간 추적에서 재발이 없었다. 재발에 영향을 미치는 것으로 흉부엑스선상 기흉의 크기가 작은 경우에는 재발율이 더 높았고, 수술자의 경험이 중요하였다.

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Recovery Trajectory in Tachycardia Induced Heart Failure Model (빈맥을 이용한 심부전 모델에서 회복궤도)

  • 오중환;박승일;원준호;김은기;이종국
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.422-427
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    • 1999
  • Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

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Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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