• Journal of Trauma and Injury
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• 제33권4호
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• pp.264-268
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• 2020

A 55-year-old man underwent emergent sternotomy due to cardiac tamponade occurring just after an accidental fall from a 10-m height. Tricuspid valve regurgitation was found on echocardiography while he was on mechanical ventilation after the operation. The patient was weaned successfully from mechanical ventilation after tricuspid valve repair under cardiopulmonary bypass. Traumatic tricuspid valve regurgitation is a rare blunt chest injury and its symptoms occur late. Tricuspid regurgitation should be considered as a reason for failure to wean from mechanical ventilation after blunt cardiac trauma.

• Journal of Ginseng Research
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• 제33권4호
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• pp.283-293
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• 2009

Ginsenosides, one of the most well-known traditional herbal medicines, are used frequently in Korea for the treatment of cardiovascular symptoms. The effects of ginseng saponin on ischemia-induced isolated rat heart were investigated through analyses of hemodynamic changes including perfusion pressure, aortic flow, coronary flow, and cardiac output. Isolated rat hearts were perfused and then subjected to 30 min of global ischemia followed by 60 min of reperfusion with modified Kreb's Henseleit solution. Myocardial contractile function was continuously recorded. Ginseng saponin administered before inducing ischemia significantly prevented decreases in perfusion pressure, aortic flow, coronary flow, and cardiac output. The ginseng saponin administered group significantly recovered all of the hemodynamic parameters, except heart rate, after ischemia-reperfusion (I/R) compared with ischemia control. The intracellular calcium ($[Ca^{2+}]_i$) content in rat neonatal cardiomyocytes was quantitatively determined. Administration of ginseng saponin significantly prevented $[Ca^{2+}]_i$ increase that had been induced by simulated I/R in vitro (p<0.01) in a dose-dependent manner, suggesting that the cardioprotection of ginseng saponin is mediated by the inhibition of $[Ca^{2+}]_i$ increase. Overall, we found that the administration of ginseng saponin has cardioprotective effects on the isolated rat heart after I/R injury. These results indicate that ginseng saponin has distinct cardioprotective effects in an I/R-induced rat heart.

• 성인간호학회지
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• 제26권5호
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• pp.573-583
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• 2014

Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

• Clinical and Experimental Pediatrics
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• 제54권2호
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• pp.86-89
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• 2011

Traumatic ventricular septal defect (VSD) resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

• The Korean Journal of Physiology and Pharmacology
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• 제26권2호
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• pp.87-94
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• 2022

Myocardial infarction promotes cardiac remodeling and myocardial fibrosis, thus leading to cardiac dysfunction or heart failure. Peiminine has been regarded as a traditional anti-fibrotic Chinese medicine in pulmonary fibrosis. However, the role of peiminine in myocardial infarction-induced myocardial injury and fibrosis remained elusive. Firstly, rat model of myocardial infarction was established using ligation of the left coronary artery, which were then intraperitoneally injected with 2 or 5 mg/kg peiminine once a day for 4 weeks. Echocardiography and haemodynamic evaluation results showed that peiminine treatment reduced left ventricular end-diastolic pressure, and enhanced maximum rate of increase/decrease of left ventricle pressure (± dP/dt max) and left ventricular systolic pressure, which ameliorate the cardiac function. Secondly, myocardial infarction-induced myocardial injury and infarct size were also attenuated by peiminine. Moreover, peiminine inhibited myocardial infarction-induced increase of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α production, as well as the myocardial cell apoptosis, in the rats. Thirdly, peiminine also decreased the myocardial fibrosis related protein expression including collagen I and collagen III. Lastly, peiminine reduced the expression of p38 and phosphorylation of extracellular signal-regulated kinase 1/2 in rat model of myocardial infarction. In conclusion, peiminine has a cardioprotective effect against myocardial infarction-induced myocardial injury and fibrosis, which can be attributed to the inactivation of mitogen-activated protein kinase pathway.

• 대한임상독성학회지
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• 제13권2호
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• pp.62-70
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• 2015

Purpose: Cardiac complications may occur in cases of organophosphate (OP) poisoning. However, a few studies regarding patterns of cardiac toxicity as determined by transthoracic echocardiography (TTE) after exposure to OP have been reported. In the current study, the authors examined cardiac functions using TTE in patients with myocardial injury caused by exposure to OP. Methods: A retrospective review was conducted on 16 consecutive cases of OP poisoning with myocardial injury (defined as elevated troponin I within 48 hours of arrival at the regional emergency center in South Korea and diagnosed and treated at the center from January 2012 to November 2014. Results: TTE was performed in 11 (69%) of the 16 patients with an elevated troponin I (TnI) level within 48 hours. Of these 11 patients, 5 patients (45.5%) exhibited reduced ejection fraction (EF), and 3 exhibited regional wall motion abnormality (RWMA). Two patients (18.2%) had both reduced systolic function and RWMA. Two of the 5 patients with reduced EF returned to normal systolic function, however two patients did not regain normal systolic function after admission. One patient expired due to multiple organ failure, and 4 patients were transferred with a moribund status. Twelve of 15 patients who survived to discharge (at 4 to 35 months) were followed. Five of these patients died during follow-up and 7 survived without further complications. Conclusion: OP can cause reversible cardiac dysfunction including reduced systolic function and RWMA. Serum TnI may be useful for initial assessment of cardiac function during the workup of patients suffering from OP poisoning. After the initial assessment of cardiac enzyme, further evaluation with TTE in patients with abnormal cardiac enzyme will be necessary to understand the cardiac toxicity.

• The Korean Journal of Physiology and Pharmacology
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• 제27권2호
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• pp.143-155
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• 2023

Percutaneous coronary intervention and acute coronary syndrome are both closely tied to the frequently occurring complication of coronary microembolization (CME). Resveratrol (RES) has been shown to have a substantial cardioprotective influence in a variety of cardiac diseases, though its function and potential mechanistic involvement in CME are still unclear. The forty Sprague-Dawley rats were divided into four groups randomly: CME, CME + RES (25 mg/kg), CME + RES (50 mg/kg), and sham (10 rats per group). The CME model was developed. Echocardiography, levels of myocardial injury markers in the serum, and histopathology of the myocardium were used to assess the function of the cardiac muscle. For the detection of the signaling of TLR4/MyD88/NF-κB along with the expression of pyroptosis-related molecules, ELISA, qRT-PCR, immunofluorescence, and Western blotting were used, among other techniques. The findings revealed that myocardial injury and pyroptosis occurred in the myocardium following CME, with a decreased function of cardiac, increased levels of serum myocardial injury markers, increased area of microinfarct, as well as a rise in the expression levels of pyroptosis-related molecules. In addition to this, pretreatment with resveratrol reduced the severity of myocardial injury after CME by improving cardiac dysfunction, decreasing serum myocardial injury markers, decreasing microinfarct area, and decreasing cardiomyocyte pyroptosis, primarily by blocking the signaling of TLR4/MyD88/NF-κB and also reducing the NLRP3 inflammasome activation. Resveratrol may be able to alleviate CME-induced myocardial pyroptosis and cardiac dysfunction by impeding the activation of NLRP3 inflammasome and the signaling pathway of TLR4/MyD88/NF-κB.

• Journal of Chest Surgery
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• 제22권4호
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• pp.698-704
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• 1989

We experienced the seven cases of penetrating and non-penetrating cardiac injuries combined with cardiac tamponade from June 1986 to June 1989 at Seoul and Chun-An Hospital of SOONCHUNHYANG medical college. The results were as follows. l. In sex distribution, 7 cases were male. In age distribution, The fourth decades occupied about 58 % of all cases. 2. In mode of injury, 4 cases were stab wounds, 1 case penetration by metallic fragment, 2 cases blunt chest trauma. 3. We routinely checked the CVP with subclavian vein catheterization in case of suspicious cardiac tamponade. Significant increments were showed in 4 cases. 4. Becks triad [low blood pressure, raised central venous pressure, distant heart sound] were recorded in 43 % of the cases with proven tamponades. 5. The sites of injury included RV in 4 cases, LV in 1 case, RA in 1 case and branch of RCA in 1 case. The RV injuries were the most common. 6. Coronary artery damage occurred in 2 cases. LADA was severed in 1 case combined with RV rupture and branch of RCA was torn 1 case. 7. Pericardiocentesis was performed 1 case at another hospital before referring to our hospital. We have never used the procedure because we think that it is potentially dangerous with no clear benefit. 8. Subxyphoid pericardial window was performed in 2 cases of severe cardiac tamponade. We have employed this method to stabilize the patients who had systolic hypotension. 9. Surgical approaches were performed with median sternotomy in 3 cases, thoracotomy in 4 cases. 10. We undertook the simple closure in 6 penetrating cardiac wounds. The removal of impacted metallic fragment was performed under the cardiopulmonary bypass. Simple ligation was performed in 2 cases of coronary artery severance 11. One patient with no sign of life was urgently intubated and undertaken an emergency room thoracotomy on the stretch car without antiseptic preparation. The cardiorrhaphy in 6 cases were performed in the operating theater 12. One patient undertaken emergency room thoracotomy did not survive due to refractory hypovolemic shock. But the remaining 6 patients recovered.

• The Korean Journal of Physiology and Pharmacology
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• 제28권3호
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• pp.285-294
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• 2024

Myocardial infarction is one of the leading causes of mortality globally. Currently, the pleiotropic inflammatory cytokine interleukin-6 (IL-6) is considered to be intimately related to the severity of myocardial injury during myocardial infarction. Interventions targeting IL-6 are a promising therapeutic option for myocardial infarction, but the underlying molecular mechanisms are not well understood. Here, we report the novel role of IL-6 in regulating adverse cardiac remodeling mediated by fibroblasts in a mouse model of myocardial infarction. It was found that the elevated expression of IL-6 in myocardium and cardiac fibroblasts was observed after myocardial infarction. Further, fibroblast-specific knockdown of Il6 significantly attenuated cardiac fibrosis and adverse cardiac remodeling and preserved cardiac function induced by myocardial infarction. Mechanistically, the role of Il6 contributing to cardiac fibrosis depends on signal transduction and activation of transcription (STAT)3 signaling activation. Additionally, Stat3 binds to the Il11 promoter region and contributes to the increased expression of Il11, which exacerbates cardiac fibrosis. In conclusion, these results suggest a novel role for IL-6 derived from fibroblasts in mediating Stat3 activation and substantially augmented Il11 expression in promoting cardiac fibrosis, highlighting its potential as a therapeutic target for cardiac fibrosis.

• Journal of Chest Surgery
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• 제37권4호
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• pp.335-341
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• 2004

외상에 의한 심장 손상은 드물게 발생하지만 진단 및 치료가 지연되었을 경우 치사율이 매우 높다. 이에 본원에서는 외상성 심장 손상 환자를 대상으로 후향적 연구를 진행하였다. 대상 및 방법: 1995년 3월부터 2002년 7월까지 본원 응급실을 통하여 내원한 외상성 심장 손상 환자 대상으로 하였다. 총 17명의 환자 중 흉기 등에 의한 자상이 5예, 둔상 중에서 교통사고로 인한 손상이 7예, 작업장 등에서 추락한 경우가 4예, 원인을 알 수 없는 경우가 있었다. 모든 예에 있어서 응급 수술을 진행하였고, 6예의 경우 심폐기를 이용한 수술을 진행하였다. 결과: 수술 후 4예의 사망이 있었다. 수술 후 모든 환자는 중환자실로 이송하였고 평균 중환자실 재원기간은 3.86$\pm$3.35일, 평균 총재원기간은 18.27$\pm$14.99일이었다. 응급실에 도착하여 수술의 진행까지 생명 징후가 비교적 안정적이었던 경우 사망한 예는 없었다. 결론: 수술 전의 환자의 상태는 환자의 예후에 직접적인 영향을 주는 중요한 인자이기 때문에 흉부외상 환자에게 있어서 심장손상 여부의 판단은 매우 중요하다.