• Title/Summary/Keyword: Cardiovascular disorder

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CABG for Treating Unstable Angina with Multivessel Coronary Artery Aneurysms - A case report- (다혈관 관상동맥류가 동반된 불안정성 협심증 환자에서의 관상동맥 우회로술)

  • Kim, Jin-Sik;Chee, Hyun-Keun;Chung, Jin-Woo;Kim, Jun-Seok;Shin, Je-Kyoun;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.743-746
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    • 2010
  • Coronary artery aneurysm is an uncommon disease. The optimal medical or surgical treatment for this disease remains obscure. The causes of coronary artery aneurysms include atherosclerosis, Kawasaki disease, infectious vascular disease, connective tissue disorder and congenital malformation. A 50 year old man visit our institution for chest pain that had started 3 days previously. After coronary angiography, multiple coronary aneurysms were diagnosed and successful surgical intervention was performed.

The Intoxication of Beta Blocker with Psychiatric Drugs Focused on the Cardiovascular Adverse Effects (베타차단제를 포함한 정신과적 약물 중독: 심혈관계 영향을 중심으로)

  • Joo, Sung Woo;Min, Young-Gi;Choi, Sang-Cheon;Park, Eun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.100-106
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    • 2016
  • Purpose: Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system. Methods: A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled. Results: Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis. Conclusion: Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

A Case Report of Noonan Syndrome with Mental Retardation and Attention-Deficit Hyperactivity Disorder (정신지체와 주의력결핍 과잉행동장애를 보이는 Noonan 증후군 1예)

  • Kim, Won-Woo;Shim, Se-Hoon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.1
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    • pp.31-35
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    • 2012
  • Noonan syndrome is characterized by short stature, typical facial dysmorphology, and congenital heart defects. The main facial features of Noonan syndrome are hypertelorism with down-slanting palpebral fissures, ptosis, and low-set posteriorly-rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency, and lymphatic dysplasias. The patient is a 10-year-old boy. He had experienced repeated febrile convulsions. He had typical facial features, a short stature, chest deformity, cryptorchidism, vesicoureteral reflux, and mental retardation. His language and motor development were delayed. When he went to school, it was difficult for him to pay attention, follow directions, and organize tasks. He also displayed behavior such as squirming, leaving his seat in class, and running around inappropriately. Clinical observation is important for the diagnosis, so we report a patient who was diagnosed with Noonan syndrome, mental retardation, and attention-deficit hyperactivity disorder.

Characterization of Venous Involvement in Vasculo-Behçet Disease

  • Lee, Na Hyeon;Bae, Miju;Jin, Moran;Chung, Sung Woon;Lee, Chung Won;Jeon, Chang Ho
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.381-386
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    • 2020
  • Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

Relationship between Blood Stasis and Arterial Stiffness in the Patient with Ischemic Stroke (뇌경색 환자의 어혈변증과 동맥경직도의 관련성 연구)

  • Shin, Won-Jun;Park, Young-Min;Jeong, Dong-Won;Hong, Jin-Woo;Sun, Jong-Joo;Lee, Jun-Woo;Jung, Woo-Sang;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.241-250
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    • 2006
  • Backgrounds: Blood stasis is hon as an important pathologic factor for vascular disorder in Oriental medicine. Despite its clinical importance there have been few objective tests for diagnosing blood stasis. Objectives: This study was designed to examine the relationship between blood stasis and arterial stiffness measured by cardio-ankle vascular index (CAVI). Methods: The subjects were 104 ischemic stroke patients with onset after 14 days. Their general characteristics, lipid profiles and uric acid were recorded. The degree of arterial stiffness was assessed by CAVI, and blood stasis was evaluated by diagnostic criteria. The data were analyze4 by chi-square test, student t-test, spearman correlation analysis, and pearson correlation analysis. Then, stepwise multiple logistic regression analysis was applied in order to exclude the interactions among several factors. Results: There were significant differences in right, left and higher CAVI between the blood stasis group and the non blood stasis group (p-value<0.01). Age, systolic blood pressure, triglyceride and CAVI had relationships with blood static scores. In multiple logistic regression analysis, the adjusted odds ratio of blood stasis for arterial stiffness with CAVI above 9 were 7.091 (95% confidence interval, $1.641\sim30.638$). Conclusions: The results demonstrated the relationship between blood stasis and arterial stiffness measured by CAVI. Therefore, we suggest that CAVI should be one of the objective tests for diagnosing blood stasis.

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Surgical treatment of myasthenia gravis: a report of 10 cases (중증 근무력증의 외과적 요법: 10례 보)

  • Jo, Dae-Yun;Kim, Yong-Jin;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.292-298
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    • 1984
  • Myasthenia 8ravis is a disorder of neuromuscular function due to a reduction of available acetylcholine receptors at the neuromuscular junction. Typically, the muscle weakness is worse after effort and improved by rest. In 1939, Blalock and associated reported a case of patient with myasthenia gravis who was successfully treated by thymectomy. Since then, operation has become increasingly important in the management of this disease. From 1968 to 1983, 10 cases of myasthenia gravis were operated at the Department of Thoracic and Cardiovascular Surgery,College of Medicine, Seoul National University. 1.Among 10 cases, 4 were male and 6 were female. 2.Thymectomy was performed in 9 cases, and 1 case of malignant thymoma with deeply infiltration to adjacent structure was not resectable. 3.There was 1 operative mortality with respiratory failure. 4.During follow-up period, most of them showed symptomatic improvement, but complete remission was not noticed in any case.

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CABG in Coronary Aneurysm Due to Kawasaki Disease (가와사키병에 의한 관상동맥류의 관상동맥우회로술 -치험 1례-)

  • Kim, Jong-Uk;Lee, Jae-Won;Song, Myeong-Geun
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.398-400
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    • 1995
  • Kawasaki s disease is a multisystemic disorder that is an important cause of cardiovascular disease in children. We experienced a case of coronary artery aneurysm secondary to Kawasaki s disease. The patient was 12-year-old female presented as exertional dyspnea & chest pain[NYHA classII . Her coronary angiogram showed saccular aneurysms at proximal right coronary artery and proximal left anterior descending artery. CABG was performed by use of double internal mammary artery.Postoperative E.K.G. showed a normal pattern.She discharged at postoperative 10th day without problem. 4 months after discharge, she had no dyspnea & chest pain in exertion[NYHA class I .

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Hughes-Stovin Syndrome as an Outcome of Behçet Disease or as a Different Entity

  • Demirkan, Serkan;Gultekin, Yildirim
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.64-68
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    • 2018
  • Hughes-Stovin syndrome is a rare disorder of unknown etiology. Although the association between multiple pulmonary artery aneurysms and venous thrombosis of the lower limbs was reported by Beattie and Hall in 1911, it was not until 1962 that the eponym "Hughes-Stovin syndrome" was formally introduced in the medical literature. We describe 2 patients with Hughes-Stovin syndrome who presented with pulmonary artery aneurysm, thrombophlebitis, hemoptysis, and oral ulcers, review the manifestations of the disease, and compare its similarities with and differences from Behçet disease.

Diagnosis and Treatment of Sleep Apnea (수면무호흡증의 진단과 치료)

  • Lee, Sang-Haak;Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.5-11
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    • 2003
  • Sleep apnea syndrome is a common clinical disorder characterized by intermittent cessation of airflow at nose and mouth during sleep. The clinical significance of this syndrome is that it is one of the most common causes of excessive daytime sleepiness. It can also cause neuropsychiatric, cardiovascular, and cerebrovascular complications. The standard for diagnosis of sleep apnea syndrome is nocturnal polysomnography. Because polysomnography is a time-consuming and expensive test, many efforts have been made to replace polysomnography with a simpler system of monitoring, but no method has yet been approved as a definitive investigation method. The goals of treatment for this syndrome are to eliminate excessive daytime sleepiness and to reduce the risk of possible cardiovascular complications. Continuous positive airway pressure is the most definite and widely accepted treatment for achieving these goals. Other treatments such as surgical treatment, oral appliances, and behavioral therapy may be useful for selected patients who are mildly affected.

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Valve Sparing Aortic Root Replacement in Children with Loeys-Dietz Syndrome

  • Sim, Hyung-Tae;Seo, Dong Ju;Yu, Jeong Jin;Baek, Jae Suk;Goo, Hyn Woo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.272-276
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    • 2015
  • Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.