• 지역사회간호학회지
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• 제21권4호
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• pp.409-418
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• 2010

Purpose: This study aimed to estimate the effects of a regular walking exercise program on metabolic syndrome, cardiovascular risk factors, and depressive symptoms among the elderly with diabetic mellitus (DM) based on the Theory of Reasoned Action (TRA). Methods: This study has randomized and stratified experimental design with experimental and control groups. We developed a regular walking exercise program suitable for the elderly with DM based on the guidance of AAHPERD. The experimental group participated in the regular walking exercise program, which contains walking exercise 3 times a week and 50 minutes each time for 3 months and education on controlling diet and preventing complications once a week and 20 minutes each time for 4 weeks. Post-test was conducted after 3 months to estimate metabolic syndrome, cardiovascular risk factors, and depressive symptoms. Results: The regular walking exercise program was effective for decreasing the waist size, the level of fasting blood glucose (FBG) and triglyceride (TG), cardiovascular risk factors and the severity of depressive symptoms among the elderly with DM. Conclusion: The incidence of complications would be decreased by applying a regular walking exercise program.

• Journal of Chest Surgery
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• 제42권4호
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• pp.528-531
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• 2009

경식도 초음파는 심장수술에서 비교적 안전하게 수술 중 심장의 기능 및 수술 결과를 평가할 수 있어 그 이용이 일반화되고 있으며, 경식도 초음파 관련 합병증은 드물지만 하인두 손상이나 식도 천공 등 위험한 합병증이 생길 수 있다. 폐부종을 동반한 심근경색으로 진단받은 77세 남자환자에서 심폐 바이패스를 사용하 않는 관상동맥우회술 시행 후, 수술 중 경식도 초음파 시술과 관련되어 발생한 것으로 추정되는 pyriform sinus 천공 및 이에 동반된 경부 심부감염을 경험하여 보고하는 바이다.

• Journal of Chest Surgery
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• 제43권4호
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• pp.433-436
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• 2010

폐절제후 발생하는 급성폐동맥색전증은 매우 드물지만 높은 사망률을 보인다. 이는 폐절제후 발생하는 가장 위험한 합병증 중에 하나이다. 폐엽절제 후 아무런 합병증 없이 회복 중이던 환자에서 갑자기 발생한 급성폐동맥색전증으로 보존적 치료에도 악화되어 응급 색전제거술로 치료하여 좋은 결과를 얻었기에 문헌 고찰과 함께 발표하는 바이다.

• Journal of Chest Surgery
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• 제27권8호
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• pp.669-676
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• 1994

Because the number of patients who require maintenance hemodialysis is increasing in number recently, angioaccess has become important to many vascular surgeons participating in the management of such patients.The authors created 269 arteriovenous fistulas[AVF] for angioaccess in 229 patients with chronic renal failure[CRF] at the Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from August 1990 to March 1993. We analyzed the results of 260 operations for 220 patients except 9 patients who were lost during the follow up period. We performed snuffbox AVF in 171 cases, classic radiocephalic AVF in 46 cases, direct AVF at other site in 5 cases, forearm Gore-Tex AVF in 29 cases, and upper arm Gore-Tex AVF in 9 cases. We experienced 13 cases of operative failures, 11 cases of early complications, and 60 cases of late complications including obstructions during follow-up period. The 1 year, 2 year and 3 year patency rates of snuffbox AVF[Group 1], classic radiocephalic AVF[Group 2], and Gore-Tex AVF[Group 3] are like followings; 89, 84, 76% in group 1, 84, 75, 68% in group 2, and 79, 66, 55% in group 3. It showed a statistically significant difference between group 1, 2 and group 3.

• Journal of Chest Surgery
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• 제27권4호
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• pp.272-280
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• 1994

Total 400 St.Jude Medical Bileaflet Valves were implanted in 336 pts from January 1983 to June 1993; 64 were aortic, 205 were mitral, 64 were double valve and 3 were tricuspid position. The follow up period extended from 6 months to 10 years[mean 24.3 months]. Male to female ratio was 1:1.7. There were total 27 deaths[cardiac related 20, cardiac non-related 7]. Overall mortality was 2.9%/pt-yr. There were 10 early deaths[3.0%] and 10 late cardiac related deaths [3.0%]. Prosthetic valve related complications occurred in 19 patients[5.7%] and among them, seven died; four died of thromboembolic events, two died of anticoagulants therapy related hemorrhagic complications and one died of bacterial endocarditis. NYHA class improved significantly especially in aortic valve replacement and double valve replacement. In AVR cases, the mean NYHA was 2.8 preoperatively and 1.3 postoperatively. And in DVR cases, 3.3 preoperatively and 2.2 postoperatively. The decision to employ a particular prosthesis was made according to the anticipated or known complications of the valve. The St.Jude Medical Valve retains all the hazards of other mechanical valves, most notably, thromboembolism. But the hemodynamic performance of St.Jude Medical Valve compared most favorably with other substitute valves in many reports. 0ur experience didn`t show any differences compared other authors in terms of valve related complication. So we concluded St. Jude Medical Valve can be primarily considered in the selection of artificial valve except in the patients when the usage of anticoagulant therapy is contraindicated.

• Journal of Chest Surgery
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• 제21권3호
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• pp.497-509
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• 1988

Current therapy of aortic dissections remains unstandardized because of the relative rarity of these catastrophic events and conflicting reported results of various therapeutic strategies. Hence, we reviewed our current results and planned to purify our method of interpretation of results and so, to standardize therapeutic managements. This study comprised unselected, consecutive 27 patients with aortic dissections who were operated at Seoul National University Hospital from Jan 1983 to March 1988. The results from analysis of their preoperative, operative and postoperative finding were as follows: 1] 7 patients had acute type A, 14 had chronic type A, 4 had acute type B, and 2 had chronic type B. 2] The causes of dissections were unclear, but 8 patients had Marfan`s syndromes, 2 had previous operative histories on cardiovascular systems and 2 had congenital heart diseases. 3] Multiple preoperative variables were found to correlate significantly with operative mortality and complications. The prevalences of such preoperative major complicating factors were significantly more frequent in acute than chronic [P < 0.05] and type A than type B [P < 0.01]. 4] Operations were performed according to the type of the dissections and whether it was acute or chronic. Usually dacron tube graft replacements were performed[25/26]. Intraluminal sutureless graft replacement was performed in 11 patients. Of the 14 patients with combined aortic regurgitation, concomitant aortic valve resuspension in 4, seperative aortic valve replacement in 1, and aortic valve replacement with coronary reimplantation were performed in 9 patients. 2 patients had concomitant arch vessel managements. 5] Over-all operative mortality rate was 33% and 54% for acute type A, 25% for acute type B, 29% for chronic type A, 0% for chronic type B respectively. The main causes of operative mortality were cardiovascular complications [mainly CPB-weaning failure] in acute cases and hemorrhagic complications in chronic cases.

• Journal of Chest Surgery
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• 제22권1호
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• pp.42-49
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• 1989

A total of 420 pyrolytic carbon mechanical valves were implanted in 336 patients from January, 1984, through Jung, 1988. Of the valves implanted, 131 were Bjork-Shiley, 250 St-Jude, and 39 Duromedics. The cumulative follow-up was 398 patient-years with a mean follow-up of 14.4 months per patients. Among 336 patients, 175 had mitral, 68 aortic, 82 multiple, 10 tricuspid, and one pulmonary valve replacement. The hospital mortality figures were 9 of 336[2.67%] in all, 5 of 175[2.85%] in isolated mitral, 1 of 68[1.47%] in isolated aortic and 3 of 82[3.65%] in multiple valve replacement. The causes of hospital mortality were myocardial failure in 5, sepsis in 2, bleeding in 1, cerebral embolism in l. There was no late valve related mortality. The actuarial survival rate at 4.5years was 99.4*0.1%. The complications occurred in 15 of 336[4.46%]; 7 of 175[4.0%] in isolated mitral, 4 of 68[5.88%] in isolated aortic, and 4 of 82[4.89%] in multiple valve replacement. The causes of complications were thromboembolism in 4, hemorrhage in 4, paravalvular leakage in 4, hepatitis in 2, and complete AV block in l. Actuarial probability of survival at 4.5 years was 95.0*0.1%. The low mortality and complications encourage us to applicate these valves to any patient including children and young women.

• Journal of Chest Surgery
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• 제53권2호
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• pp.58-63
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• 2020

Background: Despite progress in treatment, Stanford type A aortic dissection is still a life-threatening disease. In this study, we analyzed surgical outcomes in patients with Stanford type A aortic dissection according to the extent of surgery at Daegu Catholic University Medical Center. Methods: We retrospectively analyzed 98 patients with Stanford type A aortic dissection who underwent surgery at our institution between January 2008 and June 2018. Of these patients, 82 underwent limited replacement (hemi-arch or ascending aortic replacement), while 16 patients underwent total arch replacement (TAR). We analyzed in-hospital mortality, postoperative complications, the overall 5-year survival rate, and the 5-year aortic event-free survival rate. Results: The median follow-up time was 48 months (range, 1-128 months), with a completion rate of 85.7% (n=84). The overall in-hospital mortality rate was 8.2%: 6.1% in the limited replacement group and 18.8% in the TAR group (p=0.120). The overall 5-year survival rate was 78.8% in the limited replacement group and 81.3% in the TAR group (p=0.78). The overall 5-year aortic event-free survival rate was 85.3% in the limited replacement group and 88.9% in the TAR group (p=0.46). Conclusion: The extent of surgery was not related to the rates of in-hospital mortality, complications, aortic events, or survival. Although this study was conducted at a small-volume center, the in-hospital mortality and 5-year survival rates were satisfactory.

• Journal of Chest Surgery
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• 제52권5호
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• Journal of Chest Surgery
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• 제56권6호
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• pp.414-419
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• 2023

Background: The recurrence of ventricular arrhythmias (VAs) in patients who have already undergone treatment with antiarrhythmic medication, catheter ablation, and the insertion of implantable cardioverter defibrillators is not uncommon. Recent studies have shown that bilateral cardiac sympathetic denervation (BCSD) effectively treats VAs. However, only a limited number of studies have confirmed the safety of BCSD as a viable therapeutic option for VAs. Methods: This single-center study included 10 patients, who had a median age of 54 years (interquartile range [IQR], 45-65 years) and a median ejection fraction of 58.5% (IQR, 56.2%-60.8%), with VAs who underwent video-assisted BCSD. BCSD was executed as a single-stage surgery for 8 patients, while the remaining 2 patients initially underwent left cardiac sympathetic denervation followed by right cardiac sympathetic denervation. We evaluated postoperative complications, the duration of hospital stays, and VA-related symptoms before and after surgery. Results: The median hospital stay after surgery was 2 days (IQR, 2-3 days). The median surgical time for BCSD was 113 minutes (IQR, 104-126 minutes). No significant complications occurred during hospitalization or after discharge. During the median follow-up period of 13.5 months (IQR, 10.5-28.0 months) from surgery, no VA-related symptoms were observed in 70% of patients. Conclusion: The benefits of a short postoperative hospitalization and negligible complications make BCSD a safe, alternative therapeutic option for patients suffering from refractory VAs.