• Title/Summary/Keyword: Cardiac diseases

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Review on some diseases which are differentiated with AMI (심근경색과 감별할 주요질환)

  • Kim, Jeong-A
    • The Journal of the Korean life insurance medical association
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    • v.31 no.1
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    • pp.10-14
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    • 2012
  • The importance of the diseases which are differentiated with acute myocardial infarction (AMI) cannot be overemphasized in insurance medicine. Although there are lots of diseases similar with AMI, in this paper, 5 diseases were described; Myocardial bridging, cocaine toxicity, myocarditis, cardiac syndrome X, and Takotsubo syndrome. Costs of the interventions like coronary angiography or echocardiography are relatively low in Korea compared to western countries. Therefore, detection of those diseases has been increased recently and illegal drug addiction also has been increased probably due to globalization. In conclusion, the knowledge of those diseases dealt with this article could be helpful for the person who is related to insurance medicine.

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Benign Esophageal Stricture (양성 식도 협착)

  • An, Jae-Ho;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1052-1059
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    • 1988
  • 297 cases of military personnel and 7 cases of civilian were operated in K.A.F.C.H. from January 1982 to October 1988 due to cardiovascular disease, which consist of 202 cases [66.4%] of vascular disease, 91 cases [29.9%] of cardiac disease, and 11 cases [3.6%] of pericardial disease. Mean age was 25.8*7.2[2S.D.] year of age and nearly all patients were male except 4 cases of female patient in civilian. Of the 253 cases [83.2%] of acquired disease, vascular diseases were 149 cases [583%], traumatic cardiovascular 54 [21.3%], cardiac 40 [15.8%], and pericardial 10 [4.0%]. Of the 51 cases [16.8%] of congenital diseases, cardiac anomalies were 48 cases [94.1%], vascular 2 [3.9%] and pericardial 1 [2.0%]. Open heart surgery was done in 83 cases of cardiac disease, which consists of 39 cases [46.9%] of valvular heart disease, 22 cases [26.59o] of ASD, 14 cases [16.9%] of VSD, 2 cases [2.4%] of partial ECD, and so on. Of the 6 cases [2.0%] of over-all mortality, operative death in open heart surgery was 4 cases[4.8%].

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Light-Chain Cardiac Amyloidosis: Cardiac Magnetic Resonance for Assessing Response to Chemotherapy

  • Yubo Guo;Xiao Li;Yajuan Gao;Kaini Shen;Lu Lin;Jian Wang;Jian Cao;Zhuoli Zhang;Ke Wan;Xi Yang Zhou;Yucheng Chen;Long Jiang Zhang;Jian Li;Yining Wang
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.426-437
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    • 2024
  • Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with light-chain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49-63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At follow-up after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%-1.1%] vs. 1.7% [-5.5%-7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%-1.3%] vs. 2.0% [-3.0%-5.0%]; P = 0.01) compared with those with inferior response. Conclusion: Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.

Tanshinone IIA reduces pyroptosis in rats with coronary microembolization by inhibiting the TLR4/MyD88/NF-κB/NLRP3 pathway

  • Li, Hao-Liang;Li, Tao;Chen, Zhi-Qing;Li, Lang
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.5
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    • pp.335-345
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    • 2022
  • Pyroptosis is an inflammatory form of programmed cell death that is linked with invading intracellular pathogens. Cardiac pyroptosis has a significant role in coronary microembolization (CME), thus causing myocardial injury. Tanshinone IIA (Tan IIA) has powerful cardioprotective effects. Hence, this study aimed to identify the effect of Tan IIA on CME and its underlying mechanism. Forty Sprague-Dawley (SD) rats were randomly grouped into sham, CME, CME + low-dose Tan IIA, and CME + high-dose Tan IIA groups. Except for the sham group, polyethylene microspheres (42 ㎛) were injected to establish the CME model. The Tan-L and Tan-H groups received intraperitoneal Tan IIA for 7 days before CME. After CME, cardiac function, myocardial histopathology, and serum myocardial injury markers were assessed. The expression of pyroptosis-associated molecules and TLR4/MyD88/NF-κB/NLRP3 cascade was evaluated by qRT-PCR, Western blotting, ELISA, and IHC. Relative to the sham group, CME group's cardiac functions were significantly reduced, with a high level of serum myocardial injury markers, and microinfarct area. Also, the levels of caspase-1 p20, GSDMD-N, IL-18, IL-1β, TLR4, MyD88, p-NF-κB p65, NLRP3, and ASC expression were increased. Relative to the CME group, the Tan-H and Tan-L groups had considerably improved cardiac functions, with a considerably low level of serum myocardial injury markers and microinfarct area. Tan IIA can reduce the levels of pyroptosis-associated mRNA and protein, which may be caused by inhibiting TLR4/MyD88/NF-κB/NLRP3 cascade. In conclusion, Tanshinone IIA can suppress cardiomyocyte pyroptosis probably through modulating the TLR4/MyD88/NF-κB/NLRP3 cascade, lowering cardiac dysfunction, and myocardial damage.

Left Ventricle Segmentation Algorithm through Radial Threshold Determination on Cardiac MRI (심장 자기공명영상에서 방사형 임계치 결정법을 통한 좌심실 분할 알고리즘)

  • Moon, Chang-Bae;Lee, Hae-Yeoun;Kim, Byeong-Man;Shin, Yoon-Sik
    • Journal of KIISE:Software and Applications
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    • v.36 no.10
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    • pp.825-835
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    • 2009
  • The advance in medical technology has decreased death rates from diseases such as tubercle, pneumonia, malnutrition, and hepatitis. However, death rates from cardiac diseases are still increasing. To prevent cardiac diseases and quantify cardiac function, magnetic resonance imaging not harmful to the body is used for calculating blood volumes and ejection fraction(EF) on routine clinics. In this paper, automatic left ventricle(LV) segmentation is presented to segment LV and calculate blood volume and EF, which can replace labor intensive and time consuming manual contouring. Radial threshold determination is designed to segment LV and blood volume and EF are calculated. Especially, basal slices which were difficult to segment in previous researches are segmented automatically almost without user intervention. On short axis cardiac MRI of 36 subjects, the presented algorithm is compared with manual contouring and General Electronic MASS software. The results show that the presented algorithm performs in similar to the manual contouring and outperforms the MASS software in accuracy.

Cardiac Dysfunction Is Not Associated with Increased Reintubation Rate in Patients Treated with Post-extubation High-Flow Nasal Cannula

  • Sim, Jae Kyeom;Choi, Juwhan;Oh, Jee Youn;Min, Kyung Hoon;Hur, Gyu Young;Lee, Sung Yong;Shim, Jae Jeong;Lee, Young Seok
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.332-340
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    • 2022
  • Background: Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period. Methods: We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation. Results: Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292). Conclusion: Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.

A Study on the Radionuclide Cardiac Angiography in the Various Heart Diseases (각종(各種) 심질환(心疾患)에서 방사성(放射性) 동위원소(同位元素) 심혈관촬영술(心血管撮影術)에 관한 연구(硏究))

  • Chung, June-Key;Park, Sun-Yang;Ryu, Park-Young;Cho, Bo-Yeon;Kim, Byoung-Kuk;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.13 no.1_2
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    • pp.7-14
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    • 1979
  • Radionuclide cardiac angiography has distinct advantages in safety, patient comfort, cost and ease of performance. This method offers diagnostic accuracy equivalent to that of cardiac catheterization. By this method the qualitative and quantitative diagnosis of the cardiac shunts are available. Also for it is repeatable with ease and more physiologic, it has application in following pre- and post-operative shunt patients. We performed the radionuclide cardiac angiographies in 147 cases of heart diseases and 26 cases of normal group. 1. The detection of left-to-right shunt was possible in 22 of 24 patients, and 2 patients were not diagnosed due to small shunt amount. (Qp/Qs<1.3) In 21 patients of right-to-left shunt, all were diagnosed by radionuclide cardiac angiography. 2. With the pulmonary time-activity curve, $C_2/C_1$ ratio was calculated. In normal control group, a range of $C_2/C_1$ ratios of $21{\sim}38%$ was established with a mean value of $28.6{\pm}4.6%$. In patients with left-to-right shunts determined by catheterization data, the range of $C_2/C_1$ ratio was $33{\sim}90%$, with a mean value of $67.8{\pm}12.2%$. 3. In 8 cases of left-to-right shunt, $Q_p/Q_s$ ratios determined by radionuclide cardiac angiography were compaired with those of cardiac catheterization. The correlation coefficient was 0.907. (P<0.001) 4. Postoperative radionuclide cardiac angiographies were done in 21 cases. 3 of 13 patients with left-to-right shunts were found to have residual shunts. 8 patients with right-to-left shunts were confirmed to have no residual shunt.

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The Role of Enzyme Replacement Therapy in Fabry Disease in Cardiology Perspective

  • Hongo, Kenichi
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.4 no.1
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    • pp.21-25
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    • 2018
  • Fabry disease is a hereditary lysosomal storage disorder caused by the reduction or absence of lysosomal enzyme alpha-galactosidase A and the accumulation of glycosphingolipids, such as globotriaosylceramide (Gb3), in various organs, including the heart. The prevention of cardiac involvement in Fabry disease can only be achieved by enzyme replacement therapy (ERT), and the method of assessing the efficacy of ERT should be confirmed. Changes in the electrocardiogram, such as the shortening of PQ interval, prolongation of QTc and repolarization abnormalities as well as left ventricular hypertrophy in voltage criteria, can be used to identify Fabry disease patients; however, the usefulness of electrocardiograms for evaluating the efficacy of ERT is limited. The assessment of left ventricular hypertrophy using echocardiography has been established to evaluate the efficacy of ERT during long-term period. A new technique involving speckled tracking method might be useful for detecting early cardiac dysfunction and identifying the effect of ERT for a relatively short period. The estimation of left ventricular hypertrophy using cardiac magnetic resonance (CMR) is also useful for assessing the efficacy of ERT. Identifying late gadolinium enhancement in CMR may affect the effectiveness of ERT, and the new technique of T1 mapping might be useful for monitoring the accumulation of Gb3 during ERT. Histopathology in cardiac biopsy specimens is another potentially useful method for identifying the accumulation of GB3; however, the use of histopathology to evaluate of the efficacy of ERT is limited because of the invasive nature of an endomyocardial biopsy.

Cardiopulmonary Resuscitation: New Concept

  • Lee, Kwang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.401-408
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    • 2012
  • Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.