• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.523-528
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• 2006

Purpose : The purpose of this study was to investigate the relationship between depression and resilience in adolescents with congenital heart disease(CHD) and to identify the variables associated with depression. Methods : The Resilience Scale(cronbach's ${\alpha}=0.92$), Children's Depression Inventory(cronbach's ${\alpha}=0.72$) and Maternal Behavior Research Instrument(cronbach's ${\alpha}=0.88$) were applied and analyzed to assess depression and resilience among 231 adolescents after surgery for CHD from three major cardiac centers in Korea. This group consist of 114 males and 117 females. The mean age was 15.8 years(range : 13-18 years). The clinical severity of illness was rated by CHD functional index and NYHA functional class. Results : The mean score for depression and resilience was 16.74(range : 0-49) and 115.84(range : 70-132) respectively. Depression was significantly related to age(r=0.25, P<0.001) and NYHA functional class(r=0.35, P<0.001), as well as being negatively correlated with oxygen saturation(r=-0.39, P<0.001), academic achievement(r=-0.41, P<0.001), parental attitude(r=-0.49, P<0.001) and resilience (r=-0.59, P<0.001). The results of multiple regression analysis showed that parental attitude(${\beta}=-0.48$, P<0.01) and resilience(${\beta}=-0.62$, P<0.01) were related to depression. Conclusion : This study demonstrated that adolescents with CHD had a higher resilience and were less depressed with an affectionate parent. With respect to medical and nursing intervention programs, it is essential to identify strengths of adolescents with CHD in order to increase their resilience. Additionally, it is also important that parenting and counseling programs be implemented for the parents of adolescents with CHD.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.593-606
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• 1984

With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.41-47
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• 2010

Purpose : Adiponectin is an endogenous modulator of vascular remodeling that suppresses vascular inflammation. However, the role of adiponectin in Kawasaki disease (KD) has not been elucidated. The purpose of this study is to investigate the correlation between serum adiponectin level and several parameters, such as interleukin (IL)-6, tumor necrosis factor $(TNF)-{\alpha}$, lipid profile, and C reactive protein (CRP), and to clarify the association between adiponectin and cardiac function. Methods : Twenty-two KD patients (22 patients in acute phase and 20 patients in subacute phase) were enrolled in the study group. The control group consisted of 31 subjects (13 febrile patients and 18 healthy children). Both groups underwent blood sampling and tissue Doppler imaging (TDI). Results : CRP was significantly increased in the KD group compared with the control group. There were no significant differences in serum $TNF-{\alpha}$, IL-6, and adiponectin levels between groups. However, a negative correlation was found between adiponectin level and CRP level or platelet count. Systolic myocardial velocity and A myocardial velocity measured by TDI were decreased significantly in the acute KD group compared with the subacute KD group and control group. Positive correlations were found between adiponectin level and systolic myocardial velocity or A myocardial velocity. Conclusion : In acute KD patients, low adiponectin level was related to severe inflammatory reactions and decreased left ventricular functions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.366-379
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• 2017

In this study, we performed a systematic review and meta-analysis to identify the effects of exercise on endothelial progenitor cells (EPCs) in patients with cardiovascular disease (CVD). We conducted database searches (Cochrane Library, PubMed, EMBASE, ScienceDirect, CINAHL, Scopus, KoreaMed, KISS, RISS, KMBASE) for the effect of exercise on cardiovascular disease, using heart disease, coronary artery disease, heart failure, cardiovascular disease, exercise, motor activity, rehabilitation, and endothelial progenitor cells as the keywords. Of the 539 studies identified, 9 met the inclusion and exclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze the effect size and the publication bias was checked with a funnel plot. Exercise was found to improve the VEGF (vascular endothelial growth factor), CD34+KDR+, and endothelial function, assessed via FMD (flow-mediated dilation), in the exercise vs. control groups, viz. 2.008 (95% CI 0.204-3.812), 1.399 (95% CI 0.310-2.489), and 1.881 (95% CI 0.848-2.914), respectively. Exercise improved the VEGF, number of EPCs, and endothelial function in the CVD patients. Considering the increasing prevalence and mortality rates for cardiovascular disease in Korea, the findings of this study that analyzed the effects of exercise on EPCs might provide guidelines for planning exercise interventions for patients with CVD.

• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.47-51
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• 2009

Hepatopulmonary syndrome (HPS) is characterized by a defect in arterial oxygenation that's induced by pulmonary vascular dilatation in the setting of liver disease. Some studies have shown the relationship between the presence of the HPS and the severity of liver disease, but there are only rare cases of HPS inpatient with Child-Pugh class A liver cirrhosis. We report here on a case of a 58 years-old male who suffered from progressive dyspnea for the previous few years. He was diagnosed with alcoholic liver cirrhosis 5 years previously. There was no significant abnormality on the chest radiograph and transthoracic echocardiography, but the arterial blood gas analysis revealed severe hypoxemia. Contrast-enhanced transesophageal echocardiograpy with agitated saline demonstrated a delayed appearance of microbubbles in the left cardiac chambers. Thus, he was finally diagnosed with HPS. This case suggests that we should consider HPS when a patient with compensated liver cirrhosis has unexplained dyspnea.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.183-187
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• 2017

Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascular-related underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.267-273
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• 1996

Takayasu's arteritis(aortoarteritis) is a chronic inflammatory disease involving the aorta, the arteries arising from the aorta, and the pulmonary arteries also may be involved. The inflammation leads to either stenosis and occlusion of the involved artery or formation of aneurysm or both. The arterial lesions can lead to secondary hypertension, retinopathy, cardiac involvement, cerebrovascular events, and premature death. The course and prognosis of patients with aortoarteritis show wide variation, and few authors have published systematic studies documenting the natural history of this disease. While the etiology of Takayasu's arteritis remains unknown, various modes of treatment including steroids, vascular surgery, and balloon angioplasty have been used for management of these patients. We experienced a case of Takayasu's arteritis with multiple occlusion of pulmonary arteries, which was confirmed by angiography and perfusion scan, so reported it with a review of literature.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.900-907
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• 2020

Objective: To investigate the predictive value of intraplaque neovascularization (IPN) for cardiovascular outcomes. Materials and Methods: We evaluated 217 patients with coronary artery disease (CAD) (158 men; mean age, 68 ± 10 years) with a maximal carotid plaque thickness ≥ 1.5 mm for the presence of IPN using contrast-enhanced ultrasonography. We compared patients with (n = 116) and without (n = 101) IPN during the follow-up period and investigated the predictors of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, coronary artery revascularization, and transient ischemic accident/stroke. Results: During the mean follow-up period of 995 ± 610 days, the MACE rate was 6% (13/217). Patients with IPN had a higher maximal thickness than those without IPN (2.86 ± 1.01 vs. 2.61 ± 0.84 mm, p = 0.046). Common carotid artery-peak systolic velocity, left ventricular mass index (LVMI), and ventricular-vascular coupling index were significantly correlated with MACE. However, on multivariate Cox regression analysis, increased LVMI was independently related to MACE (p < 0.05). The presence of IPN could not predict MACE. Conclusion: The presence of IPN was related to a higher plaque thickness but could not predict cardiovascular outcomes better than conventional clinical factors in patients with CAD.

• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.625-630
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• 2006

Background: Pulmonary hypertension in COPD patients is the result of a direct effect of tobacco smoke on the intrapulmonary vessels with the abnormal production of the mediators that control vasoconstriction, vasodilatation, and vascular cell proliferation, which ultimately lead to aberrant vascular remodeling and physiology. COPD patients are prone to the developmint of an acute and chronic thromboembolism with an elevation of the plasma procoagulant and fibrinolytic markers However, the roles of the coagulation and fibrinolysis system on the right ventricular dysfunction in COPD patients are not well defined. We examined the alteration of the coagulation and fibrinolysis system in COPD patients according to the right ventricular function measured using cardiac multidetector computed tomography (MDCT). Methods: The right ventricular ejection fraction (RVEF) was measured using cardiac MDCT in 26 patients who were diagnosed with COPD according to the definition of the GOLD guideline. The plasma level of thrombin antithrombin (TAT) and plasminogen activator inhibitor (PAI)-1 were measured using an enzyme linked immunoassay. Results: The plasma TAT was markedly elevated in COPD patients ($10.5{\pm}19.8{\mu}g/L$) compared with those of the control ($3.4{\pm}2.5{\mu}g/L$) (p<0.01). However, the plasma PAI-1 in COPD patients ($29.6{\pm}20.7ng/mL$) was similar to that in the controls. The plasma TAT showed a significant inverse relationship with the RVEF measured by the cardiac MDCT in COPD patients (r=-0.645, p<0.01). However, the plasma PAI-1 did not show a relationship with the RVEF (r=0.022, p=0.92). Conclusion: These results suggest that the coagulation system in COPD patients is markedly activated, and that the plasma level of TAT might be a marker of a right ventricular dysfunction in COPD patients.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.50-56
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• 1997

Gated SPECT can evaluate the regional wall motion of the heart. We evaluated the regional wall motion of the perfusion abnormality in conventional perfusion SPECT with gated SPECT. In case of suspicious perfusion abnormalities, we tried to differentiate the artifact from true abnormality in coronary vascular disease using gated SPECT. We thought that artifacts would have normal wall motion, whereas fixed defects with decreased wall motion would probably represent coronary artery disease. A total of 275 patients who were performed coronary angiography and T1-201 rest/Tc-99m MIBI dipyridamole stress gated SPECT within 2 months were enrolled. In coronary angiography, stenosis more than 50% was considered as coronary artery disease. After injection of 111MBq T1-201 rest image was obtained on triple head SPECT system. 370MBg Tc-99m MIBI was used for the stress image. Eight-frame per-cardiac-cycle gated Tc-99m SPECT studies were done. All the images were analyzed visually. Using perfusion SPECT, the overall sensitivity and specificity were 87% and 55% respectively. Regarding artery territory, sensitivity and specificity were 68% and 73% for left anterior descending artery(LAD), 62% and 78% for right coronary artery(RCA), 42% and 90% for left ciramflex artery(LCX). Using gated SPECT, the overall sensitivity and specificity were 87% and 66% respectively. Sensitivity and specificity were 68% and 78% for LAD, 62% and 79% for RCA, 42% and 90% for LCX. Among 21 false positive cases in perfusion SPECT, 5 cases were interpreted as true negative with gated SPECT. We conclude that gated SPECT provides a valuable adjunct to perfusion SPECT in characterizing perfusion abnormalities and to improve specificity.