• Title/Summary/Keyword: Bleeding heart

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A Case Report of Gastroesophageal Reflux Disease(GERD) with Hiatal Hernia (식도열공탈장을 동반한 위식도 역류성 질환 환자 치험 1례)

  • Park, Jung-Han;Cho, Hyun-Seok;Kim, Jung-Chul;Oh, Sung-Won;Lee, Sang-Hoon;Kim, Byoung-Woo;Lee, Jae-Eun
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.244-251
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    • 2005
  • Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. It causes various symptoms(heart bum, chest pain, dysphagia, vomiting etc.) when it is associated with a condition called gastroesophageal reflux disease(GERD). In this occasion, complications included bleeding because of the erosion, ulceration and inflammation of the mucosa. For treatment, there are $H_2$ blockers and proton pump inhibitors, but they have many side effects. In Oriental Medicine effectively treated cases are rare. Therefore, it is essential to seek radical agents and effective treatments for these disorders. In this case report, these disorders are approached by focusing on the deficit of 'yin(陰)'especially 'pi-yin(脾陰)'. Desired results were seen with herbal medications which enhance the 'yin(陰)', especially through 'wuyin-jian(五陰煎)' which enhances the 'pi-yin(脾陰)'. This is reported to contribute to development of future treatments.

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Operative Treatment for Cardiac Tamponade with Ventricular Rupture of Post Myocardial Infarction without Cardiopulmonary Bypass - A case report - (급성심근경색 후 발생한 양심실파열로 인한 심장압전에서 체외순환의 사용없이 시행한 수술적 치료 - 1예 보고 -)

  • Choi, Chang-Seock;Kim, Han-Yong;Park, Jae-Hong
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.95-97
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    • 2008
  • Ischemic ventricular rupture is one of the most fatal complications following myocardial infarction, and this requires prompt diagnosis and operation. A 75-year-old female was admitted to the ER in a semicomatous mentality with cyanotic extremities. Cardiac echography was carried out in the ER, and a $1.5{\sim}2\;cm$ thickness of effusion in the pericardium was seen. Because the patient's heart had declined to 35 times per min, an emergency operation was started while giving cardiac massage. After observing a 1 cm rupture on the right ventricular wall and a necrotic hemorrhagic scar with a rupture on the left ventricular apical wall, repair of the ruptured areas with a large Satinsky clamp was carried out to control bleeding without cardiopulmonary bypass. On the 28th day after surgery, she was discharged home with a minimal degree of dyspnea.

Surgical Treatment for Rupture of the Right Common Iliac Artery Caused by Transcatheter Balloon Aortic Valvuloplasty in a Baby with Congenital Aortic Stenosis - A case report - (선천성 대동맥 판막 협착증에서 풍선 판막 성형술 중 발생한 총장골 동맥 파열의 외과적 치료 -1예 보고 -)

  • Han, Jong-Hee;Kim, Yong-Ho;Yu, Jeong-Hwan;Kim, Si-Wook;Kil, Hong-Ryang;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.116-119
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    • 2008
  • Transcatheter interventions are widely used for diagnosis and treatment of congenital heart disease. Complications associated with transcatheter interventions are uncommon. However, when they occur they are most often self-limited. Rarely, however, serious catheter related complications occur that may require emergent surgical intervention. In this case, the right common iliac artery was disrupted during transcatheter balloon valvuloplasty during the treatment of congenital aortic stenosis in a 2-week-old baby. After immediate surgical intervention with bleeding control using two balloon catheters the baby did well. Here we report this case and review the medical literature.

Infantile Hepatic Hemangioendothelioma: Seventeen Years of Experience at a Single Center (소아 간 혈관내피종 : 17년간의 치료경험)

  • Kwon, Hyung-Joo;Moon, Suk-Bae;Park, Kwi-Won;Jung, Sung-Eun
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.134-143
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    • 2008
  • Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular hepatic tumor in children. We analyzed the 17-year experience of IHHE. The medical records of 16 patients (M:F=8:8) treated at the Department of Pediatric Surgery and the Department of Pediatrics Seoul National University Children's Hospital between January 1991 and January 2008 were reviewed retrospectively. Mean age at presentation was 87 days (1 day - 551 days). Seventy five percent of patients were diagnosed with imaging study and 25 % with biopsy. Major symptoms were hepatomegaly (N=5), palpable abdominal mass (N=4) and congestive heart failure (N=3). Six patients had no symptoms. Kasabach-Merritt syndrome was combined in one patient. Nine patients (56.3 %) underwent operation and 2 patients (12.5 %) underwent only medical treatment. Clinical observation was tried on 5 patients (31.3 %) without any treatment. Operation was performed on the patient with clinical symptoms or on patients where the differentiation between begin and malignant could not be determined. Patients who had clinical symptoms but tumor was unreresectabile were treated medically. Among the 5 patients who had been observed for their clinical course, 2 patients showed complete regression and the tumors of the remaining 3 patients were regressing. Clinical symptoms, the age at presentation, the size of tumor and ${\alpha}$-FP, all had no significant statistical relationship with the time required for complete tumor regression. There was no relationship between the size change of the tumor and the change of ${\alpha}$-FP level. Only the size of tumor was related with clinical symptoms. One patient died of post-operatvie bleeding. Treatment plan was determined by the extent of the tumor and the presence of clinical symptoms. Observation was enough for the patients without clinical symptoms and complete resection was curative for patients with clinical symptoms. Medical treatment is an alternative for the patient whose tumor is unresectable.

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Formation of Gametophytes and Development of Zygotic Embryo in Dicentra spectabilis (금낭화(Dicentra spectabilis)의 배우체 형성 및 접합자배의 발달)

  • Sim Ock-Kyeong;Lee Kang-Seop;Kim Ee-Yup;Eun Jong-Seon
    • Korean Journal of Plant Resources
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    • v.18 no.2
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    • pp.302-308
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    • 2005
  • This study was carried out to obtain the basic informations on the characteristics of gametophytes formation and embryo developement in Dicentra spectabilis. Microspore mother cells developed from archesporial cells, start meiosis when flower bud length reaches around 1 mm, formed tetrahedral type tetrad. The 4 microspores were separated. They were developed to male gametophytes, respectively. Megaspore mother cells were observed when flower bud length was $4{\sim}5\;mm$. The developemental type of megaspore was polygonum and embryo sac was amphitropous. Three large and distinctive antipodals did not degenerated and remained after embryo sac was developed. When the male and female gametophytes was fully developed, the length of stamen and style was very similar or stamen was shorter about 0.5 mm than that of style. This result indicates that self-fertilization can be occurred in this species. After fertilization, developing zygotic embryos showed various stages of development from globular to cotyledonary embryos, and zygotic embryo in seed scattering time seemed to have an early cotyledonary stage.

A Clinical Study of Patent Ductus Arteriosus (동맥관개존증의 임상적 고찰)

  • 이선희
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.672-680
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    • 1988
  • Munro is generally considered the first person to have demonstrated, in 1888, in an infant cadaver, the feasibility of dissection and ligation of a persistently patent ductus arteriosus. In august, 1938, Robert Gross reported first successful division and suture of the patent ductus of 7 year old girl. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. Seventy-eight consecutive cases of closure of patent ductus arteriosus were operated from June 1980 to June 1988 in the department of thoracic and cardiovascular surgery in Maryknoll Hospital. Retrospective clinical analysis of the patients were 1. There were 24 males, 54 females. 2. The age range of the patients were from 7 months to 32 years with the mean age 9.8 years. 3. Chief complaints of the patients were frequent URI[70.5%], dyspnea on exertion[36.9%], palpitation[10.3%], but 15 patients[19.2%] had no subjective symptoms. 4. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 66 patients[84.6%]. The other 12 patients made systolic murmur. 5. Radiographic findings of the Chest P-A were cardiac enlargement in 55 patients[70%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 68 patients[87%]. 6. Electrocardiographic findings of the patients were within normal limit in 23 patients[36%], LVH in 38 patients[48.7%], RVH in 7 patients[9%], biventricular hypertrophy in 5 patients[6%]. 7. Cardiac catheterization performed in 62 patients. Mean Qp/Qs=2.5, mean pulmonary arterial pressure=45 mmHg. 8. 73 patients were operated through left posterolateral thoracotomy: Closure of the ductus by ligation in 64 cases, division with suture in 6 cases, and division with aortopatch in 3 cases. Ligation through median sternotomy under cardiopulmonary bypass were 5 cases. 9. There was no death associated with operation, but one case was experienced with intraoperative tearing of ductus resulting in massive bleeding. The other complications were transient hoarseness in 2 patients, chylothorax in 2 patients.

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Repair of Postinfarct Subacute Left Ventricular Free Wall Rupture Using Fibrin Glue (급성심근경색 후 발생한 아급성형 좌심실파열에서 Fibrin Glue를 이용한 치료)

  • Lee, Jae-Hoon;Noh, Dong-Sub;Kim, Jae-Bum;Park, Nam-Hee;Keum, Dong-Yoon;Choi, Sae-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.448-450
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    • 2007
  • The mortality of left ventricular free wall rupture after acute myocardial infarction is high; however, subactue myocardial rupture can be diagnosed by echocardiogram and the use of the intraaortic balloon pump reduces the incidence of re-rupture. Bleeding from subacute myocardial rupture can be managed by employing fibrin glue and several patches. We report here on a case of successfully managed case of subactue left ventricular free wall rupture after acute myocardial infarction with using the sutureless technique and fibrin glue.

Cardiac diastolic dysfunction predicts poor prognosis in patients with decompensated liver cirrhosis

  • Lee, Soon Kyu;Song, Myeong Jun;Kim, Seok Hwan;Ahn, Hyo Jun
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.409-416
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    • 2018
  • Background/Aims: Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cardiac dysfunction in patients with liver cirrhosis (LC). However, the effect of LVDD on survival has not been clarified, especially in decompensated LC. Methods: We prospectively enrolled 70 patients with decompensated LC, including ascites or variceal bleeding, at Daejeon St. Mary's Hospital from April 2013 to April 2015. The cardiac function of these patients was evaluated using 2D echocardiography with tissue Doppler imaging. The diagnosis of LVDD was based on the American Society of Echocardiography guidelines. The primary endpoint was overall survival. Results: Forty-four patients (62.9%) had LVDD. During follow-up (22.3 months), 18 patients died (16 with LVDD and 2 without LVDD). The survival rate was significantly lower in patients with LVDD than in those without LVDD (31.1 months vs. 42.6 months, P=0.01). In a multivariate analysis, the Child-Pugh score and LVDD were independent predictors of survival. Moreover, patients with a ratio of early filling velocity to early diastolic mitral annular velocity (E/e') ${\geq}10$ (LVDD grade 2) had lower survival than patients with E/e' ratio < 10. Conclusions: The presence of LVDD is associated with poor survival in patients with decompensated LC. Therefore, it may be important to monitor and closely follow LVDD patients.

Evaluation of Pain Reduction and Clinical Efficacy of Feedback-Controlled Ultrasonic Scaler

  • Min-ju Kim;Hee-jung Lim;Myoung-hee Kim;Young-sun Hwang;Im-hee Jung
    • Journal of dental hygiene science
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    • v.23 no.2
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    • pp.176-184
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    • 2023
  • Background: Recently, a piezoelectric ultrasonic scaler based on a feedback control mechanism was introduced for pain relief. This study aimed to investigate the effects of a new ultrasonic scaler in reducing pain and discomfort in adults. Methods: A newly introduced ultrasonic scaler (Master 700®) was used as the test device and a conventional ultrasonic scaler device (PIEZON®) was used as the control device. Forty-one healthy adults visited the dental clinic for dental scaling but did not undergo scaling or periodontal treatment within 6 months. Intraoral examinations were performed before scaling and 3 months later; before scaling, both devices were randomly assigned on the left or right side of each dentition (split-mouth model) and scaling was performed by a registered dental hygienist. The levels of pain and discomfort during scaling were evaluated subjectively and objectively using the visual analog scale (VAS) and physiological monitoring of the heart rate (HR), respectively. Time was measured for each device. Results: All clinical indicators, except bleeding on probing, significantly improved with both devices. The treatment times were 7 minutes, 13 minutes (control) and 6 minutes, 59 minutes (test). VAS scores for pain were 4.89±2.12 (control) and 4.58±2.77 (test) points out of 10; for noise, these were 4.68±2.33 (control) and 4.55±2.55 (test), and for vibration, the values were 4.26±2.0 (control) and 4.18±2.48 (test). HR averages were 72.34±3.39 (control) and 75.97±9.78 (test) beats/min. No statistically significant differences were observed between the devices. Conclusion:The pain, discomfort levels, and scaling time of the new piezoelectric ultrasonic scaler did not differ from those of the conventional device. Further research and development are necessary for more prominent pain-relief effects of scaling devices.

Clinical Results of Aortic Valve Replacement (대동맥판 치환술의 임상 성적)

  • Na, Guk-Ju;O, Jeong-U;An, Byeong-Hui;Kim, Sang-Hyeong
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.152-157
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    • 1997
  • From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. worthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age(median : 43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients(6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients : repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1 Used valves were 51. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturlal survival rate was 85.3%. Postoperative complications were low cardiac utput in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79 $\pm$ 0.66 preoperatively to 1.25 $\pm$ 0.49 postoperatively(p < 0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57 $\pm$ 0.06 to 0.54 $\pm$ 0.05 (p < 0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.

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