• Journal of Preventive Medicine and Public Health
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• v.53 no.1
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• pp.37-44
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• 2020

Objectives: This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients. Methods: As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated. Results: Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44). Conclusions: Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.53-59
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• 2016

Background: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. Methods: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities. Results: Survey participants responded that South Korea needs governmental policies to alleviate the concentration of cardiovascular surgery patients in large metropolitan hospitals. Participants agreed that the freedom to choose medical institutions and improved accessibility to metropolitan hospitals due to advanced transportation systems were some of the causes for the concentration. A majority (98.7%) of respondents thought establishing thoracic and cardiovascular surgery centers in provinces was an appropriate solution to alleviate the concentration. Thoracic and cardiovascular surgery specialists were ranked as the number one group on which to focus development. Conclusion: Developing and carrying out policies to establish thoracic and cardiovascular surgery centers in provinces will alleviate the regional imbalance in available heart surgery services and an overall improvement in cardiovascular disease treatment in South Korea.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.151-156
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• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• Journal of Chest Surgery
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• v.53 no.2
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• pp.41-48
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• 2020

Background: Chylothorax after congenital heart surgery is not an uncommon complication, and it is associated with significant morbidity. However, consensus treatment guidelines are lacking. To improve the treatment outcomes of patients with postoperative chylothorax, we implemented a standardized management protocol at Severance Hospital in September 2014. Methods: A retrospective review of patients treated at a single center was done. All corrective and palliative operations for congenital heart disease performed at our institution between January 2008 and April 2018 were reviewed. The incidence and treatment outcomes of postoperative chylothorax were analyzed. Results: The incidence of chylothorax was 1.9%. Sixty-one percent of the patients could be managed with a low-fat diet, while 28% of the patients required complete restriction of enteral feeding. Thoracic duct embolization was performed in 2 patients and chest tube drainage decreased immediately after the procedure. No patient required thoracic duct ligation or pleurodesis. After implementation of the institutional management protocol, the number of chest tube drainage days decreased (median, 24 vs. 14 days; p=0.45). Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice protocol helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax.

• Research in Community and Public Health Nursing
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• v.26 no.2
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• pp.150-159
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• 2015

Purpose: This study was performed in order to identify the relationships among self-care behavior, health conservation, and cardiovascular risk factors and to examine the influence of self-care behavior and health conservation on cardiovascular risk factors among Korean elders with diabetes mellitus. Methods: The participants were 105 elders with diabetes mellitus using senior welfare centers and elderly leisure houses in Daegu. Data were collected through interviews during the period from April to May in 2014. Self-care behavior was measured with Kim's (1997) Self-care Behavior Scale, health conservation with Sung's (2005) Health Conservation Scale, and cardiovascular risk factors with the Arizona Heart Institute Cardiovascular Risk Factor Questionnaire. Collected data were analyzed through one-way ANOVA, independent t-test, Pearson's correlation, and stepwise multiple regression using the SPSS/WIN 19.0 program. Results: A negative correlation was found between self-care behavior and cardiovascular risk factors, and between health conservation and cardiovascular risk factors. Self-care behavior explained 6% and health conservation did 49% of variance in elderly diabetes mellitus patients' cardiovascular risk. Conclusion: The results indicate that, in order to reduce cardiovascular risk factors among Korean elders with diabetes mellitus, we need nursing interventions for increasing health conservation and self-care behavior.

• 대한약리학회:학술대회논문집
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• 2006.11a
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• pp.41-41
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• 2006

• Journal of Chest Surgery
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• v.24 no.10
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• pp.993-999
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• 1991

Congenital cysts of the mediastinum are rare, but interesting lesions. Such cysts are important because they may produce distressing symptoms and because some have a malignant potential. Mediastinal cysts of foregut origin represent an important diagnostic group. Classified according to their anomalous embryonic origins they include pericardial, bronchogenic, esophageal, enteric, and nonspecific cysts. A series of 11 consecutive surgically treated cases from the Dep. of Thoracic & Cardiovascular Surgery in National Medical Center from Oct. 1959 to Dec. 1990, all successfully resolved without mortality. The 8 bronchogenic, 1 enteric, & 2 non specific cysts are included in this series. And 2 of 11 were asymptomatic patients presented. The clinical & pathological behavior of the individual cysts comprise a wide variety of patterns. Proper utilization of the many diagnostic tests available can accurately characterize the cysts. The exact histologic diagnosis, however, is rarely made prior to operation.

• Journal of Chest Surgery
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• v.53 no.2
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• pp.79-81
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• 2020

Treatment options for children with end-stage heart failure are limited. We report the first case of a successful pediatric heart transplantation bridged with a durable left ventricular assist device in Korea. A 10-month-old female infant with dilated cardiomyopathy and left ventricular non-compaction was listed for heart transplantation. During the waiting period, the patient's status deteriorated. Therefore, we decided to provide support with a durable left ventricular assist device as a bridge to transplantation. The patient was successfully bridged to heart transplantation with effective support and without any major adverse events.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.2
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• pp.97-107
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• 2016

Purpose : Cardiovascular disease is major factor of mortality in worldwide. Previous studies shown that the socioeconomic factors, nutrition factors, health behavior factors, biological factors and co-morbidity are increasing a prevalence of cardiovascular disease. Method : This study examined the risk factors for cardiovascular disease among adults aged 30 years and older using the data from the 2012 to 2014 Korean National Health and Nutrition Examination Survey (KNHANES). The study participants were 7,555 Cardiovascular disease includes hypertension, stroke, angina pactoris, and myocardial infarction. Descriptive statistic and multivariates logistic regression were calculated. Result : The overall prevalence of cardiovascular disease was 31.16% in the participants. Cardiovascular disease was significantly associated with gender, age, income, education, marital status as socioeconomic factors in unadjusted model. After adjusting socioeconomic status variables, past smoker (OR 1.27, 95% CI 1.05-1.55), obesity (OR 7.14, 95% CI 4.21-12.11), skipping a meal (OR 2.79, 95% CI 2.46-3.16), HDL-C (OR 0.99, 95% CI 0.98-0.99) and WC (OR 1.06, 95% CI 1.05-1.07) were associated with cardiovascular disease. Conclusion : The results marked the importance of finding high risk groups and an early management of cardiovascular disease.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.952-955
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• 2001

Pulmonary arteriovenous malformations(PAVM) are uncommon diseases. Brain abscesse could be a rare and devastating comlplication of PAVM. Central nervous complaints may be the first manifestations of PAVM. We report a case of PAVM presented by brain abscess which was treated by craniotomy.