• 제목/요약/키워드: Cardiopulmonary disease

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심폐기 질환의 체계적인 진단과 장기-치료 관찰 (Systematic Diagnosis and Long-term Care of Cardiopulmonary Disease)

  • 김재웅
    • 한국식품영양학회지
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    • 제11권2호
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    • pp.171-178
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    • 1998
  • K14 환자는 유방암 수술, 방사선 치료, 피부이식 수술, 무릎 관절통의 기왕력이 있는 고령의 여성 호흡 곤란증 환자로서 문진과 진찰, 혈압, 비만도 측정, 임상병리, 흉부 X-선, 심전도와 심초음파, 폐기능 검사 등 체계적인 심폐기 질환의 진단 결과 비난증과 고혈압, 좌심실 비대, 만성 폐질환의 소견이 있어 심폐기능 모두에서 문제성이 발견되었다. 검사 결과들의 정밀한 판독법 및 장기-치료 관찰 결과를 임상문헌과 함께 고찰하였다.

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Occupational Lung Diseases: Spectrum of Common Imaging Manifestations

  • Alexander W. Matyga;Lydia Chelala;Jonathan H. Chung
    • Korean Journal of Radiology
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    • 제24권8호
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    • pp.795-806
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    • 2023
  • Occupational lung diseases (OLD) are a group of preventable conditions caused by noxious inhalation exposure in the workplace. Workers in various industries are at a higher risk of developing OLD. Despite regulations contributing to a decreased incidence, OLD remain among the most frequently diagnosed work-related conditions, contributing to significant morbidity and mortality. A multidisciplinary discussion (MDD) is necessary for a timely diagnosis. Imaging, particularly computed tomography, plays a central role in diagnosing OLD and excluding other inhalational lung diseases. OLD can be broadly classified into fibrotic and non-fibrotic forms. Imaging reflects variable degrees of inflammation and fibrosis involving the airways, parenchyma, and pleura. Common manifestations include classical pneumoconioses, chronic granulomatous diseases (CGD), and small and large airway diseases. Imaging is influenced by the type of inciting exposure. The findings of airway disease may be subtle or solely uncovered upon expiration. High-resolution chest CT, including expiratory-phase imaging, should be performed in all patients with suspected OLD. Radiologists should familiarize themselves with these imaging features to improve diagnostic accuracy.

Association Between Leisure Time Physical Activity, Cardiopulmonary Fitness, Cardiovascular Risk Factors, and Cardiovascular Workload at Work in Firefighters

  • Yu, Clare C.W.;Au, Chun T.;Lee, Frank Y.F.;So, Raymond C.H.;Wong, John P.S.;Mak, Gary Y.K.;Chien, Eric P.;McManus, Alison M.
    • Safety and Health at Work
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    • 제6권3호
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    • pp.192-199
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    • 2015
  • Background: Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters in Hong Kong. Methods: Male firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four "normal" 24-hour working shifts and during real-situation simulated scenarios. Results: Overall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities. Conclusion: Leisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

경동맥 혈류 속도 및 산소 포화도 측정을 위한 다중모드 패치형 프로브 개발 (A development of a multimodal patch-type probe for measuring blood flow and oxygen saturation in carotid artery)

  • 윤상연;이기준;김재관;황재윤
    • 한국음향학회지
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    • 제38권4호
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    • pp.443-449
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    • 2019
  • 심혈관계 질환 환자가 발생 하였을 때, 환자의 뇌와 내부 장기를 보호하고 생존율을 높이기 위해서는 사건발생 이후 신속하게 응급 의료 서비스를 제공하여 경과 시간을 줄이는 것이 가장 중요하다. 뿐만 아니라 심폐소생술의 실시를 위한 판단은 경동맥의 맥을 직접 짚는 '경동맥 촉진법'은 실시자의 주관적인 판단과 약해진 심혈관 기능에 따른 뇌혈류 차단을 할 수 있다. 본 연구는 개발된 다중 초음파 도플러 채널 쌍과 산소포화도 측정 모듈이 결합된 패치형 프로브를 이용하여 경동맥의 혈류 속도, 맥박, 산소포화도를 생체 내 실험을 통해 정성적으로 측정하였다. 따라서 본 시스템은 응급 상황에서 정량적이고 신속하게 환자의 심폐 기능을 모니터링 하여 심폐소생술 판단 여부를 객관적으로 제공하여 응급 상황 시 심혈관계 질환 환자의 생존률을 높일 수 있는 차세대 진단 기기로 활용 될 수 있다.

개심술후 출혈로 인한 응급 개흉술 81례의 임상적 고찰 (Reoperation for Hemorrhage Following Open Heart Surgery with Cardiopulmonary Bypass A Report of 81 cases)

  • 오중환
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.753-758
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    • 1985
  • Hemorrhage is an important complication after operation with cardiopulmonary bypass and sometimes necessitates a further emergency operation. Between July, 1962 and June, 1985, reoperation for hemorrhage was carried out on 81 patients [3.1%] out of a total 2634 patients who had previously undergone cardiopulmonary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Yonsei University Medical Center. There were 38 males and 43 females, with an average age of 25 years [ranging 6 months to 60 years] and an average body weight of 38 kg [ranging 5 to 77 kg].There were 43 patients of cyanotic heart disease, 32 patients of acquired valvular heart disease, 4 patients of coronary artery occlusive disease, 2 patients of ascending aorta aneurysm and annuloaortic ectasia. The average amount of blood loss in the case of cyanotic heart disease was 71.7140ml/kg, in acyanotic heart disease 45.16.3ml/kg, in acquired heart disease, 56.514.4ml/kg and in coronary artery occlusive disease, 50.618.7ml/kg during first post operative day. But there was no statistical difference [p>0.05]. The mean blood loss below 10 years old was 70.412.1 ml/kg. Those below 10 years old were believed to bleed more than any other group. But there was also no statistical difference [p>0.05]. Indications for reoperation were continued excessive blood loss [74%], cardiac tamponade or hypotension [23%] and radiological evidence of a large hematoma in the thorax and pericardium [2%]. Average bypass time was 2.10.1 hours [ranging 30 minutes to 5 hours]. The interval between operation and reoperation was as follows; less than 12 hours in 49 patients [60%], 12 to 24 hours in 20 patients [25%], 24 to 48 hours in 8 patients [10%], more than 48 hours in 4 patients [5%]. The commonest sites for bleeding were chest wall [36%], heart [34%], aorta [12%], pericardium [6%], thymus [5%] and others [6%]. But no definite source was found in ll patients [31%]. Twenty seven out of 81 patients [31%] had wound problems and 5 patients [6%] were expired. [Mean SEM]. In conclusion, in order to decrease the amount of blood loss after open heart surgery with cardiopulmonary bypass, shortening of bypass time and bleeding control at the wire suture site during chest wall closure were important. If the amount of blood loss was over 45 ml/kg or 8 m/kg/hour, reoperation should be considered as soon as possible. After operating, careful wound dressings were applied to prevent wound problems.

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소아개심술 후 시행한 순환보조장치의 임상적 고찰 (Postcardiotomy Mechanical Circulatory Support in Congenital Heart Diseases)

  • 권오춘;이영탁
    • Journal of Chest Surgery
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    • 제33권5호
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    • pp.385-390
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    • 2000
  • Background: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. Material and Method: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5$\pm$3.5 years). Result: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0$\pm$23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. Conclusion: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.

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개심술 114례의 임상적 고찰 (Clinical Evaluation of Open Heart Surgery - Review of 114 Cases -)

  • 장운하;이문금;김병린
    • Journal of Chest Surgery
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    • 제26권2호
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    • pp.115-121
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    • 1993
  • Between March, 1988 and July, 1992, 114 patients underwent Open Heart Surgery under hypothermic cardiopulmonary bypass. There were 29 cases of congenital heart anomalies (25%), and 85 cases of acquired heart diseases (75%) consisting of 53 cases of valvular heart disease, 31 cases of ischemic heart disease, and a case of left atrial myxoma. The age distribution of 114 cases was 4 to 73 years, and mean age was 43 years old consisting of mean age of congenital heart disease 23, valvular heart disease 47, and ischemic heart disease 57 years old. Overall operative mortality was about 7.9%.

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구급상황관리사에 의한 심폐소생술 안내 실태 연구 (A study on the cardiopulmonary resuscitation by the emergency medical dispatcher)

  • 김창성;피혜영;이슬기;이현범
    • 한국응급구조학회지
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    • 제25권1호
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    • pp.223-234
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    • 2021
  • Purpose: The purpose of the study is to check up the status of 119 emergency control centers usage. Therefore, the status of use of 119 emergency control centers and the incidence of pre-hospital cardiac arrest patients were investigated. Methods: The emergency activity daily reports and first aid diaries of 119 emergency control centers from January to December 2018 were reviewed. For more accurate status analysis, Among the first aid guidance received in the emergency rescue standard system, the cardiopulmonary resuscitation guide log was reviewed. Results: In 2018, the total usage of the 119 emergency control centers was 1,358,356 calls, hospital guidance werethe most commom (n=629,676, 46.4%), followed by first aid (n=428,027, 31.5%), disease consultation (n=170,238, 12.5%), medical oversight (n=111,188, 8.2%), and interhospital transfer (n=5,052, 0.4%). Regarding the user number per 1,000 persons, Jeju was the greatest at 48.0, whereas Changwon was the lowest at 13.0. A total number of dispatcher-assisted cardiopulmonary resuscitation was 12.181. The time from report to chest compression were 156.2±80.8 seconds for those with previous cardiopulmonary resuscitation training and 168.0±79.3 seconds for those without such training (p<.05). Conclusion: The ratio of first aid instructions, including dispatcher-assisted cardiopulmonary resuscitation, among total usage of the 119 emergency control centers increased. Therefore, additional efforts are required to improve the quality and expertise of information provided through the 119 emergency control centers.

소음인(少陰人) 전신부종(全身浮腫)에 대한 증례(證例) (Case about cardiogenic general edema of Soeumin apoplexy patient)

  • 신미란;김선형;김달래
    • 사상체질의학회지
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    • 제12권1호
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    • pp.265-270
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    • 2000
  • 뇌졸중을 일으키는 환자들에서 있어서 심폐의 기능적 및 기질적 이상이 선행요인으로 작용하거나 질병을 악화시키는 요인 및 합병증으로 병발되는 경우가 많다. 심폐질환이 동반된 경우 병의 진행과정이 급격히 악화될 가능성이 크며 예후가 불량한 경향을 띠므로 심폐질환에 주안점을 두어 급히 치료해야 한다. 상지대학교 한방병원 입원환자 중 뇌경색과 함께 울혈성 심부전으로 인하여 폐부종을 동반한 소음인 부종환자를 사상의학적으로 변증하고 치료하는 과정 중에 좋은 결과를 얻었기에 이에 증례보고를 하고자 한다. 68세 여환으로 우반신불수(右半身不遂) 연부장애(嚥不障碍) 어순(語純)의 중풍으로 내원하였으며 병의 진행 과정에 울혈성 심부전으로 진단되었고 폐부종의 소견과 함께 전신부종이 심하였다. 이를 소음인 부종이 태음증(太陰證)에 속한다고 하였으나 식(食) 변(便) 면(眠) 맥(脈) 설태(舌苔) 증상(症狀) 등을 종합하여 소음증(少陰證)으로 변증하고 건비이강음(建脾而降陰)의 치법(治法)에 준하여 궁귀총소이중탕(芎歸蔥蘇理中湯)을 투여하여 증상의 호전을 확인하였다.

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개심술 치험 50례 (Clinical Experiences of Open Heart Surgery [50 Cases])

  • 임진수
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.692-699
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    • 1985
  • Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

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