• Title/Summary/Keyword: Cardiac factor

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Alagille syndrome and a JAG1 mutation: 41 cases of experience at a single center

  • Ahn, Kyung Jin;Yoon, Ja Kyoung;Kim, Gi Beom;Kwon, Bo Sang;Go, Jung Min;Moon, Jin Su;Bae, Eun Jung;Noh, Chung Il
    • Clinical and Experimental Pediatrics
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    • v.58 no.10
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    • pp.392-397
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    • 2015
  • Purpose: Alagille syndrome is a complex hereditary disorder that is associated with cardiac, hepatic, skeletal, ocular, and facial abnormalities. Mutations in the Notch signaling pathway, such as in JAG1 and NOTCH2, play a key role in embryonic development. A cardiac or hepatic presentation is a critical factor for determining the prognosis. Methods: We conducted a retrospective study of 41 patients with Alagille syndrome or a JAG1 mutation between 1983 and 2013. Results: The first presentations were jaundice, murmur, cyanosis, and small bowel obstruction at a median age of 1.0 months (range, 0-24 months). The JAG1 mutation was found in 27 of the 28 genetically-tested patients. Cardiovascular anomalies were identified in 36 patients, chronic cholestasis was identified in 34, and liver transplantation was performed in 9. There was no significant correlation between the severity of the liver and cardiac diseases. The most common cardiovascular anomaly was peripheral pulmonary stenosis (83.3%), with 13 patients having significant hemodynamic derangement and 12 undergoing surgical repair. A total bilirubin level of >15 mg/dL with a complex surgical procedure increased the surgical mortality (P=0.022). Eight patients died after a median period of 2.67 years (range, 0.33-15 years). The groups with fetal presentation and with combined severe liver and heart disease had the poorest survival (P<0.001). Conclusion: The group with combined severe liver and heart disease had the poorest survival, and a multidisciplinary approach is necessary to improve the outcome.

Preoperative Levels of Hematological and Biochemical Indices Affect Perioperative Variables in Adult Patients with Coronary Artery Bypass Graft Surgery

  • Choi, Seok-Cheol;Cho, Byung-Kyu;Lee, Yong-Hwan;Chang, Kyung-Soo
    • Biomedical Science Letters
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    • v.16 no.4
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    • pp.247-258
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    • 2010
  • The objective of this research was to evaluate the relationships of preoperative (Pre-OP) levels of hematological and biochemical indices to perioperative variables in patients that underwent coronary artery bypass graft surgery (CABG). Pre-OP levels of hematological factors [total white blood cells (T-WBC), erythrocytes, hemoglobin, hematocrit, glycohemoglobin A1c (HbA1c), or platelet] were negatively or positively related with biochemical indices [alanine aminotransferase (ALT), bilirubin, glucose, fructosamine, triglyceride, and high density lipoprotein cholesterol (HDL)]. Pre-OP levels of hematological factors and biochemical indices were negatively or positively correlated with echocardiographic variables. Pre-OP level of HbA1c had a relationship with C-reactive protein. Pre-OP levels of aspartate aminotransferase (AST), ALT, HDL, glucose, fructosamine, or blood urea nitrogen (BUN) were positively or negatively associated with Pre-OP levels of cardiac markers (brain natriuretic peptide, troponin-I, creatine kinase isoenzyme 2, or CRP). Pre-OP levels of hematological factors (excepting T-WBC) related with operation time (OPT), postoperative mechanical ventilation time (POMVT), intensive care unit-period (ICU-period) or hospitalization. Pre-OP levels of AST, ALT, bilirubin, triglyceride, HDL, low dwensity lipoprotein, fructosamine, or BUN were positively or negatively correlated with OPT, graft numbers, POMVT, ICU-period or hospitalization. Retrospective this study reveals that Pre-OP levels of hematological and biochemical markers are associated with echocardiographic variables, several cardiac markers and postoperative outcomes, suggesting that Pre-OP levels of hematological and biochemical markers may be useful predictors for the diagnosis and prognosis of coronary artery disease.

Peiminine inhibits myocardial injury and fibrosis after myocardial infarction in rats by regulating mitogen-activated protein kinase pathway

  • Chen, Peng;Zhou, Dengming;Liu, Yongsheng;Wang, Ping;Wang, Weina
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.2
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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.

Ex Vivo Lung Perfusion of Cardiac-death Donor Lung in Pigs

  • Paik, Hyo Chae;Haam, Seok Jin;Park, Moo Suk;Song, Joo Han
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.154-159
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    • 2014
  • Background: Lung transplantation (LTx) is a life-saving treatment for patients with end-stage lung disease; however, the shortage of donor lungs has been a major limiting factor to increasing the number of LTx. Growing experience following LTx using donor lungs after cardiac death (DCD) has been promising, although concerns remain. The purpose of this study was to develop a DCD lung harvest model using an ex vivo lung perfusion (EVLP) system and to assess the function of presumably damaged lungs harvested from the DCD donor in pigs. Methods: The 40 kg pigs were randomly divided into the control group with no ischemic lung injury (n=5) and the study group (n=5), which had 1 hour of warm ischemic lung injury after cardiac arrest. Harvested lungs were placed in the EVLP circuit and oxygen capacities (OC), pulmonary vascular resistance (PVR), and peak airway pressure (PAP) were evaluated every hour for 4 hours. At the end of EVLP, specimens were excised for pathologic review and wet/dry ratio. Results: No statistically significant difference in OC (P=0.353), PVR (P=0.951), and PAP (P=0.651) was observed in both groups. Lung injury severity score (control group vs. study group: 0.700±0.303 vs. 0.870±0.130; P=0.230) and wet/dry ratio (control group vs. study group: 5.89±0.97 vs. 6.20±0.57; P=0.560) also showed no statistically significant difference between the groups. Conclusions: The function of DCD lungs assessed using EVLP showed no difference from that of control lungs without ischemic injury; therefore, utilization of DCD lungs can be a new option to decrease the number of deaths on the waiting list.

Surgical Repair of Truncus Arteriosus in an Low-Birth Weight Premature Baby: Right Ventricular Outflow Reconstruction with Valveless Autologous Pericardial Conduit and the Result of 20-Month′s Follow-up (저체중조산아에서 동맥간의 교정 1예: 무판막 자가심낭도관의 이용과 20개월간의 추적결과)

  • 성시찬;양승인;이헝두;김시호;우종수;이영석
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.766-771
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    • 2003
  • It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. Truncus arteriosus is a rare congenital anomaly that has an unfavorable natural course. We report a successful surgical correction of truncus arteriosus in an 13-day-old premature infant with body weight of 1.5 kg and gestational age of 32 weeks. We used autologous untreated pericardial conduit without valve in right ventricular outflow reconstruction. The patients remains in good condition with normal body weight (50 percentile) and wide right ventricular outflow tract 20 months after the operation.

Analysis of factors for intention to perform cardiopulmonary resuscitation (심폐소생술 실시의사에 대한 요인분석)

  • Leem, Seung-Hwan
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.3
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    • pp.169-179
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    • 2013
  • Purpose: The performance rate to perform Cardiopulmonary Resuscitation (CPR) by witness in out-of-hospital Cardiac Arrest (OHCA) is very low in South Korea. To prevent the death caused by OHCA, it is important to encourage the witness to perform CPR actively. The purpose of the study is to investigate the influencing factors to affect bystander CPR rate. Methods: I conducted a questionnaire survey from 25 February to 4 March, 2013, receiving responses from 517 people in Korea. The questionnaire included social demographic factors, history of heart disease, knowledge of CPR, and the reliability of emergency medical service (EMS). A logistic regression analysis was conducted. Results: Among the 517 respondents, 294 (57.4%) had intention of performing CPR. Multiple logistic regression analysis found the following significant predictors of CPR intention: gender (odds ratio [OR] = 0.390), age (OR = 1.024), religion (OR = 0.843), and knowledge of CPR (OR = 4.734). Conclusion: This study indicated that the strongest predictor is knowledge of CPR. Therefore, it would be helpful to teach CPR nationwide to encourage performing CPR. In addition, effect of CPR education in religious facilities is necessary.

Neurological complications following open heart surgery (개심술후에 발생한 신경학적 합병증)

  • Seo, Gyeong-Pil;No, Jun-Ryang;An, Jae-Ho
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.97-101
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    • 1983
  • The steadily increasing number of operations performed on the heart has given rise to occasional complications involving the nervous system, and this has been interested to cardiac surgeons and neurologists. This survey has been carried out on all Gases submitted to open heart surgery at Seoul National University Hospital during 1982 to determine which operative features were associated with the occurrence of neurological damage. 514 subjects were studied and neurological damage was noted in twenty-five patients [4.9%]. Eight of these 25 patients died in the postoperative period, but neurological damage contributed to the fatal outcome in six cases. Remaining seventeen patients were discharged without problems except one Cortical blindness and one hemiplegic patients who were survived without other problems . A number of features were found to be related to the development of neurological damage, which were age, duration of perfusion, nature of operation, cardiac rhythm and presence of the thrombi or calcification and hypothermic arrest. But many unknown etiological factors are remained out of our sight. A significant increase in the incidence of neurological damage was shown in older age group [13.3% in over 40 year of age], and also the duration of the bypass was associated with subsequent neurological injury especially more than 120 minutes [11.6%]. The presence of atrial fibrillation with intracardiac thrombi or calcification was also a contributing factor to developing neurological complication [16.7%]. These factors were regarded to influence the postoperative neurological complications and more effective method for prevention of these neurologic complication should be studied.

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Validation of Major Nursing Diagnosis-Outcome-Intervention(NANDA-NOC-NIC) Linkage for Adult Surgery Patients of Post Anesthetic Care Unit (회복실 성인 수술환자의 주요 간호진단, 간호결과 및 간호중재 연계검증)

  • Cho, Eun Jaung;Kim, Nam Cho
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.141-151
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    • 2008
  • Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

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Health Behavior and Influencing Factors in Patients with Coronary Artery Disease Admitted to Hospital (입원한 관상동맥질환자의 건강행위 영향 요인)

  • Kang, Kyung-Ja;Yu, Su-Jeong
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.1
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    • pp.16-25
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    • 2010
  • Purpose: The purpose of this study was to identify the impact that health motivation, stage of change and cardiac risk factors have on health behaviors in Korean patients with coronary artery disease(CAD) admitted to hospital. Method: The participants in this study were 127 patients with CAD hospitalized between May 2008 and July 2009. A structured questionnaire with personal interviews and chart reviews were used to collect data. Data were analyzed using the SPSS. Results: Of the relatively significant factors, including a stage of change, self efficacy, modifiable risk factor score, and perceived barriers, stage of change was found to be the most significant predictor of health behavior in patients with CAD. These variables accounted for 48.2% of the variance in health behavior. Conclusion: The results of the study indicate the necessity of developing a cardiac rehabilitation program for use in their daily lives after discharge from the hospital. Stage of change should be assessed for all patients with CAD being discharged from acute care hospitals.

Compressed-Sensing Cardiac CINE MRI using Neural Network with Transfer Learning (전이학습을 수행한 신경망을 사용한 압축센싱 심장 자기공명영상)

  • Park, Seong-Jae;Yoon, Jong-Hyun;Ahn, Chang-Beom
    • Journal of IKEEE
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    • v.23 no.4
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    • pp.1408-1414
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    • 2019
  • Deep artificial neural network with transfer learning is applied to compressed sensing cardiovascular MRI. Transfer learning is a method that utilizes structure, filter kernels, and weights of the network used in prior learning for current learning or application. The transfer learning is useful in accelerating learning speed, and in generalization of the neural network when learning data is limited. From a cardiac MRI experiment, with 8 healthy volunteers, the neural network with transfer learning was able to reduce learning time by a factor of more than five compared to that with standalone learning. Using test data set, reconstructed images with transfer learning showed lower normalized mean square error and better image quality compared to those without transfer learning.