• Title/Summary/Keyword: 진행성 심부전

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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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Clinical Efficacy of Pimobendan on Dogs with Chronic Mitral Valvular Diseases (만성 이첨판 폐쇄부전증 이환된 견에서 피모벤단의 임상적 효과)

  • Nam, So-Jeong;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.17-22
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    • 2009
  • Pimobendan is a recently developed cardiac drug which is useful to control moderate to severe congestive heart failure (CHF) from chronic mitral valvular diseases (CMVI). Because of controversy related to the efficacy and safety of pimobendan in dogs, the optimal efficacy and safety of pimobendan was assessed in 20 dogs with CMVI in this study. Scores for quality of life, respiratory failure, circulatory failure and heart failure were evaluated along with radiographical and echocardiographical assessments for about 2 months period after the addition of pimobendan into the regular cardiac medications. This study proved clear evidence that pimobendan had beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.

An Integrative Review of Health-related Quality of Life in Patients with Advanced Heart Failure (진행성 심부전 환자의 건강관련 삶의 질에 대한 통합적 고찰)

  • Son, Youn-Jung;Seo, Eun Ji
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.22-36
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    • 2019
  • Purpose: Even though advanced heart failure (HF) severely affects the patient's health-related quality of life (HRQoL), there is little information regarding this issue. This review is aimed to describe the relevant clinical characteristics of patient with advanced HF and identify factors influencing HRQoL in these patients. Methods: Empirical articles were searched from electronic databases issued from January 2000 to June 2018 with using the key terms 'heart failure' and 'quality of life'. There were a total of 22 articles that met the inclusion criteria and were analyzed for this study. Results: First, nine studies among 22 studies clearly stated that their participants were samples of patients with advanced HF. Most reviewed studies showed the New York Heart Association (NYHA) class as the criteria for identifying advanced HF. Second, the level of HRQoL varied depending on the measurement tools utilized by the researchers. Third, the NYHA class, gender, and symptoms were mainly associated with HRQoL in patients with advanced HF. Also, nurse- or physician-led intervention, exercise, spiritual-focused intervention, and palliative care improved the HRQoL of the patients with advanced HF. Conclusion: This study found that the clear application of criteria for advanced HF and the development of advanced HF-specific HRQoL measurement was needed. Prospective studies should be considered for identifying differences in the levels and factors influencing HRQoL in patients with early stage or advanced HF to design patient-centered care.

Congenital Pulmonary Vein Stenosis with Normal Anatomical Connection -One case report- (정상적인 해부학적 연결을 가진 선천성 폐정맥 협착증 -치험 1예 보고-)

  • 박준석;장윤희;정미진;강이석;전태국
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.364-368
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    • 2004
  • Congenital pulmonary vein stenosis is a rare anomaly and related to high mortality due to progressive pulmonary hypertension and heart failure in infancy. Aggressive anti-failure medication and surgical treatment is recommended. Surgical options are balloon dilatation, endovascular stent, pneumonectomy, lung transplantation, patch grafting, and sutureless repair. We report a case of congenital pulmonary vein stenosis with normal anatomical connection successfully treated with sutureless technique and using pulmonary vasodilators, such as Sildenafil, lloprost and iNO postoperatively.

Result of Surgical Treatment for Infective Endocarditis (심내막염 환자의 수술적 치료성적)

  • Choe, Sun-Ho;Yang, Hyeon-Ung;Lee, Sam-Yun
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.157-163
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    • 1996
  • Between January 1986 and June 1994, 23 patients underwent surgical intervention for infective endocarditis at Wonkwang University Hospital. There were 13 male and 5 female, ran ing in age from 13 to 67(mean 43.7 $\pm$ 5.8) years. 21 had native valve endocarditis and 2 had prosthetic valve endocardits. The most common causative organism was streptococci in 9 patients, and the others were staphylococci in 7 patients and unknown in 7 patients. The infection was in the mitral valve in 10 patients, the aortic valve in 6 patients, the aortic and mitral In 5 patients, 2 in tricuspid. Surgical indications for surgery were intractable congestive heart failure, giant growing vegetation and severe valvular insufficiency. There were 3 perioperative death (13%) and no late death. The main causes of death were cerebral embolism in 2 due to recurrent endocarditis and low cardiac output in 1. By NYHA functional classification, all patients were in class III or IV preoperatively, and all patients were improved postoperatively with HYHA functional classification in class I or II. In conclussion, early operative intervention is life-salving in patients with persistent or progres ive congestive heart failure, irrespective of the activity of the infectious process or the duration of antibiotic therapy.

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당뇨병에서 고혈압의 치료 - 첫번째 이야기

  • 이형우
    • The Monthly Diabetes
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    • s.134
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    • pp.72-73
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    • 2001
  • 당뇨병 환자에서 고혈압의 빈도는 일반인에 비해 2배 이상 높고, 대개 환자의 약 40$\~$60$\%$에서 고혈압을 동반한다. 고혈압이 당뇨병과 같이 있는 경우는 대혈관 및 미세혈관 질환의 위험인자로서 작용하여 심장사, 관상동맥 질환, 울혈성 심부전, 뇌혈관질환, 그리고 말초혈관 질환의 발생 위험을 높여 당뇨병 환자 사망원인의 대부분을 차지하며, 고혈압이 동반되어 있지 않을 경우에는 장기생존률이 높다. 또한 당뇨병에서 확장기 및 수축기 혈압은 당뇨병성 신증과 망막증의 발생 및 경과 악화에도 영향을 미친다. 당뇨병에서 고혈압이 예후에 중대한 영향을 미치는 만큼, 고혈압을 동반한 당뇨병 환자에서, 혈당의 조절뿐 아니라 죽상경화증의 예방 및 고혈압의 치료가 당뇨병에 의한 혈관 합병증의 발생과 진행을 지연시키고 사망률을 감소시키는데 결정적이라 할 수 있다.

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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.

A study on the treatment of muscle pain using a high-frequency pain treatment device (고주파 통증치료기를 이용한 근육통 치료에 대한 연구)

  • Jae-Hyun Jo
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.3
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    • pp.152-160
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    • 2023
  • After the recent COVID-19 outbreak, more and more people are paying attention to health care. Many people feel uncomfortable in life due to muscle pain after sports or exercise as a hobby and often take a break from exercise. After exercising for a long time or exercising excessively, pain appears throughout the body within 24 to 48 hours after exercise. This pain is called delayed onset muscle soreness (DOMS). In this study, the effectiveness of the pain relief of delayed onset myalgia was verified by using a high-frequency pain therapy device that generates deep heat. EMG was measured before and after pain treatment at ordinary times, RMS values were obtained through analysis, statistical analysis was performed using the SPSS program, and it was judged to be statistically significant. In addition, statistical analysis of the RMS value between normal and after pain treatment was conducted to confirm that there was no significance, and to confirm how much it returned to normal after pain treatment. In addition, since the standards for pain are different for each person even if the size of the same pain is the same, the NRS questionnaire for the size of pain was conducted, and the size of pain felt by the subjects was analyzed using the SPSS program and statistical significance was obtained. Therefore, as a result of this study, the high-frequency pain therapy device generated deep heat in the pain area to raise the temperature, and expanded the arteries and capillaries to increase blood flow, thereby increasing blood circulation and metabolism, and alleviating the pain of delayed onset muscle pain.

Dose evaluation to change the compensator in the total body irradiation (전신방사선조사에서 조직보상체의 재질변화에 따른 선량평가)

  • Lee, Dongyeon;Ko, Seongjin;Kim, Changsoo
    • Proceedings of the Korea Contents Association Conference
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    • 2014.11a
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    • pp.229-230
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    • 2014
  • 본 연구는 소아백혈병의 치료 방법 중 하나인 조혈모세포이식법의 전처치로서 사용되고 있는 전신방사선조사법에 대하여 선량분포에 대한 연구를 진행한 것으로, MCNPX 프로그램을 이용하여 모의실험을 하였다. 결과 피부선량은 평균 112.43 mGy/min, 심부장기선량은 평균 47.52 mGy/min으로 나타났으며, 조직보상체의 재질과 거리에 따라 다르게 나타나는 경향성을 볼 수 있었으며, 결과를 바탕으로 전신방사선조사를 임하기 전에 정량적인 선량평가를 할 수 있을 것으로 생각된다.

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Analysis of Childhood Rapidly Progressive Glomerulonephritis (소아 급속 진행성 사구체신염의 임상적 고찰)

  • Uhm Ji Hyun;Kim Mi Jin;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon Won;Jeung Hyeun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.78-86
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    • 2001
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

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