• Journal of Chest Surgery
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• 제24권7호
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• pp.663-668
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• 1991

To evaluate risks, complications and mortality of reoperations on heart valve prosthesis, we reviewed clinical records of 53 patients who underwent reoperation because of prosthetic valve failure[PVF], from Jan 1959 through Jun. 1991. They had undergone 48 mitral, 10 aortic valve rereplacement Primary tissue failure was the main cause of reoperation : it occurred in 51 valves at a mean postoperative interval of 58 months. Calcification and collagen disruption of prosthesis were main causes of primary tissue failure in macro and micropathology, In 3 failing mechanical prostheses, paravalvular leak was in 2 cases, another one case had the thrombi at the hinge portion. If conditions such as emergency operation with or without endocarditis, thromboembolism and advanced NYHA functional class are prevented, we think that reoperative valve replacement has similar morbidity and mortality to initial valve replacement surgery. But our sturdy represents higher mortality [22.6%] because of late surgical intervention failing the prevention of conditions leading to myocardial damage. In conclusion if the tearing, calcification, and a new murmur were detected the early reoperation should be considered to increase late survival.

• Journal of Chest Surgery
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• 제57권2호
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• pp.195-204
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• 2024

Background: Extracorporeal membrane oxygenation (ECMO) is an intervention for severe heart and lung failure; however, it poses the risk of complications, including gastrointestinal bleeding (GIB). Comprehensive analyses of GIB in patients undergoing ECMO are limited, and its impact on clinical outcomes remains unclear. Methods: This retrospective study included 484 patients who received venovenous and venoarterial ECMO between January 2015 and December 2022. Data collected included patient characteristics, laboratory results, GIB details, and interventions. Statistical analyses were performed to identify risk factors and assess the outcomes. Results: GIB occurred in 44 of 484 patients (9.1%) who received ECMO. Multivariable analysis revealed that older age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.06; p=0.0130) and need to change the ECMO mode (OR, 3.74; 95% CI, 1.75-7.96; p=0.0006) were significant risk factors for GIB, whereas no association was found with antiplatelet or systemic anticoagulation therapies during ECMO management. Half of the patients with GIB (22/44, 50%) underwent intervention, with endoscopy as the primary modality (19/22, 86.4%). Patients who underwent ECMO and developed GIB had higher rates of mortality (40/44 [90.9%] vs. 262/440 [59.5%]) and ECMO weaning failure (38/44 [86.4%] vs. 208/440 [47.3%]). Conclusion: GIB in patients undergoing ECMO is associated with adverse outcomes, including increased risks of mortality and weaning failure. Even in seemingly uncomplicated cases, it is crucial to avoid underestimating the significance of GIB.

• Journal of Nutrition and Health
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• 제32권6호
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• pp.681-690
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• 1999

The purpose of this study was to investigate whether nutrition counseling could lead to a beneficial outcomes in patients with cardiovascular disease(CVD). Fifty CVD patients(23 men and 27 women) participated in a dietary counseling program which was based on serum lipid management. Various markers of disease risk including lifestyles, anthropometric indices, eating behaviors, serum lipids, antioxidants, lipid peroxides were measured before and after the program. The program lasted 3-11 months depending on individuals. Waist/hip ratio decreased after nutrition counseling only in women. Smoking and alcohol drinking status did not change significantly after counseling. Food habit score increased significantly in both men and women(p<0.05), and patients consumed mixed cereal rice, fruits, seaweeds, legumes more frequently and snacks less frequently after nutrition counseling (p<0.05). Although intakes of energy, carbohydrate and vitamin B1 were reduced significantly after nutrition counseling, nutrient densities of calcium and iron of diets have increased significantly after nutrition counseling, and those of other micronutrients were not different Serum total cholesterol decreased significantly in men and LDL cholesterol decreased significantly in women. In women lipid peroxide level decreased and $\alpha$-tocopherol level increased significantly, while there was no significantly change in men. We conclude that well-planned nutrition counseling would reduce risks of cardiovascular disease through improving dietary behavior, lipid profile and antioxidant status.

• 대한간호학회지
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• 제31권5호
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• pp.858-870
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• 2001

Purpose: This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women. Methods: Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program. Results: 1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks(M=9.3) and at 6 month(M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension. Conclusion: The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

• Journal of Chest Surgery
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• 제32권8호
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• pp.722-725
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• 1999

배경: 개심술에서 신속하고 안전한 접근과 미관상 나은 상처를 얻기 위해, 우전외측개흉으로 성인의 심방중 격결손증과 판막질환의 수술을 시행하였다. 방법: 본원에서는 1989년부터 1998년 6월까지 우전외측 개흉술 을 통하여 44예의 개심술을 시행하였고, 수술시간, 심폐우회시간, 대동맥 차단시간, 술 후 출혈량, 중환자실 재실기간, 술 후 퇴원일 등을 정중흉골절개로 수술한 경우와 비교하였다. 결과: 두 군간의 유의한 차이는 없 었고, 전예에서 사망이나 이 접근법과 관련된 이환의 증감은 찾을 수 없었다. 우전외측 개흉술로 안전하고 만족스러운 미용상의 결과를 얻었다. 결론: 우전외측개흉술은 좋은 수술시야를 제공하고 미용상 우수하고 수술의 위험을 증가시키지 않는 부분적으로 정중흉골절개를 대신할 수 있는 안전한 접근법이다.

• Journal of Chest Surgery
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• 제45권3호
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• pp.141-147
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• 2012

Background: Although the aortic valve-sparing procedure has gained popularity in recent years, it still remains challenging in patients with advanced aortic regurgitation (AR). We compared the long-term outcomes of the aortic valve-sparing procedure with the Bentall operation in patients with advanced aortic regurgitation secondary to aortic root dilatation. Materials and Methods: A retrospective review of 120 patients who underwent surgery for aortic root dilatation with moderate to severe AR between January 1999 and June 2009 was performed. Forty-eight patients underwent valve-sparing procedures (valve-sparing group), and 72 patients underwent the Bentall procedure (Bentall group). The two groups' overall survival, valve-related complications, and aortic valve function were compared. Results: The mean follow-up duration was $4.9{\pm}3.1$ years. After adjustment, the valve-sparing group had similar risks of death (hazard ratio [HR], 0.61; p=0.45), and valve related complications (HR, 1.27; p=0.66). However, a significant number of patients developed moderate to severe AR in the valve-sparing group at a mean of $4.4{\pm}2.5$ years of echocardiographic follow-up (p<0.001). Conclusion: Both the Bentall operation and aortic valve-sparing procedure showed comparable long-term clinical results in patients with advanced aortic regurgitation with aortic root dilatation. However, recurrent advanced aortic regurgitation was more frequently observed following valve-sparing procedures.

• 한국치위생학회지
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• 제21권6호
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• pp.763-771
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• 2021

Objectives: The purpose of this study was to examine the association between periodontitis and health behavior in women aged ≥40 years. In addition, related factors were compared according to the presence or absence of cardiovascular disease. Methods: Data from the 7th Korean National Health and Nutrition Examination Survey (2016-2018) were used. The study included 3,801 women aged 40-79 years, who participated in a questionnaire health survey related to hypertension, stroke, myocardial infarction, and angina pectoris, as well as completed blood tests, anthropometry, and oral examination. Statistical analyses were performed using complex sample general linear, complex sample crosstabs, and complex sample logistic regression analyses. Results: In all subjects, smoking and drinking, use of interdental care products, and dental checkups were confirmed to be significantly related to periodontitis. In the group with cardiovascular disease, the use of interdental care products, experience in dental checkups, and toothbrushing more than three times a day were confirmed as significant factors for lowering the prevalence of periodontitis. In the group without cardiovascular disease, smoking and drinking, use of interdental care products, and experience in dental checkups were confirmed as the significant factors. Conclusions: To improve the periodontal health of women over 40 years of age with cardiovascular disease, a health education program including self-care methods for proper dental plaque management and regular dental checkups are critical. Additionally, awareness of the risks of smoking and drinking would be helpful even for women without cardiovascular diseases.

• 한국웰니스학회지
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• 제7권2호
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• pp.101-111
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• 2012

The benefits and risks of whole body vibration (WBV) based acceleration training on the human body have been documented for many years. WBV training has been shown to increase muscular strength, explosive power, bone strength, performance, mobility, cardiovascular function, circulation and anabolic hormone level and so on. The purpose of this review is correct understanding and application of WBV training. Without proper understanding, rather, to apply WBV to the human body can be fatal harm, and therefore know that what is vibration and has advantages and disadvantages. If there is anything positive side there is bound to the negative aspects. In this regard, WBV training can have a positive impact on the already confirmed by several studies and also, there have been scientifically proven. But still we are part of a scientific approach that is acceptable even to keep in mind that you will always coexist. Once again, the effect of WBV with a physical stimulus that risk and should be remembered. In addition, given the momentum and how to exercise and well-being well aware that vibration exercise as a way to think of how not to be familiar with.

• Journal of Chest Surgery
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• 제47권4호
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• pp.350-357
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• 2014

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.

• Journal of Chest Surgery
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• 제50권1호
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• pp.14-21
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• 2017

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was $55{\pm}26months$, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.