One hundred eleven cases of open heart surgery had been performed at the department of thoracic and cardiovascular surgery in College of Medicine Hallym Univ. from November 28, 1984 to August, 1991. There were 68 cases of congenital heart disease and 43 cases of acquired heart disease. Among the 68 cases of congenital heart diseases, 65 cases of acyanotic group and 3 cases of cyanotic group were noted. The majority of acquired heart diseases were valvular heart disease. The congenital heart disease consisted of 33 ASD, 27 VSD, 6 PS, 3 TOF. The sex ratio of congenital and acquired heart diseases was represented as 1.4: 1 and 1; 1.4 respectively. The age distribution of congenital heart diseases ranged from 11 months to 50 years old and that of acquired heart diseases from 15 to 61 years old. The overall operation mortality was 1 case[0.9%].
The records of 248 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular malformation during the period of 10 years from August, 1978 to July, 1988 were reviewed. During this period, the incidence of congenital cardiovascular malformation in adult was 18.2% of 1376 total heart disease operated on and 25.5% of 986 congenital heart defects. Among them, there were 200 patients in acyanotic group and 48 patients in cyanotic group. Male versus female ratio was 1:1.28. The oldest patient was 59 years old female who had atrial septal defect. The mean age was 24.4 years old. The distribution of the lesions showed a large preponderance of atrial septal defects [37.19o] followed in frequency by ventricular septal defects [918.1%], patent ductus arteriosus [17.3%], tetralogy of Fallot [16.1%], and a variety of other complex malformations[3.2%]. In the pediatric age group, relative frequency was different from that of this adult group, showing ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus and atrial septal defects in order of incidence. The hospital mortality and late mortality were 6.0% and 1.7% respectively. The causes of hospital death were low cardiac output in 10 patients, arrhythmia in 2, air embolism in 1, sepsis in 1 and respiratory failure in l. Clinical improvement upto NYHA functional class I or II postoperatively has been achieved and sustained in all patients following repair except the patients of late death and receiving reoperation. This result confirms that congenital heart defects in the adults can be corrected with a good outcome and an aggressive operative approach seems justified.
This study analysed the factors that predict and influence heart disease through key indicators related to changes in left atrial and left ventricular size. Measurements recommended by the American Society of Echocardiography were used, and the influence of variables was assessed using multiple regression analysis. The results showed that left atrial volume index(LAVI) was significantly different by age, obesity, diabetes, hypertension, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Left ventricular mass index(LVMI) was significantly different according to age, body mass index, hypertension, diabetes, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Increases in LVMI and relative ventricular wall thickness(RWT) were associated with changes in LAVI(p<0.05). Age, systolic blood pressure, increased LAVI, and RWT influenced changes in LVMI, and left ventricular dysfunction was analysed as an influencing factor for both changes in LAVI and LVMI. Therefore, changes in left atrial and left ventricular size are indicators for early diagnosis and prevention of heart disease, and it is necessary to carefully observe structural changes in the heart and actively manage risk factors for the prevention and management of heart disease.
Jo, Hyo Rim;Lee, Choung Ah;Park, Ju Ok;Hwang, Bo Na
Journal of The Korean Society of Clinical Toxicology
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v.16
no.2
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pp.116-123
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2018
Purpose: The social environment of easy access to medicines and arbitrary personal decisions leading to overdose aggravate unintentional medicine poisoning. This study aimed to investigate the characteristics of patients who visited emergency departments with unintentional medicine poisoning and reasons for poisoning based on age group. Methods: We retrospectively collected patients who experienced unintentional medicine poisoning based on data from the national injury surveillance system between 2013 and 2016. Subjects were classified into three groups based on age (0-14 years, 15-64 years, and ${\geq}65\;years$). We identified sex, insurance, time of poisoning, place, alcohol co-ingestion, hospitalization, death, and reason for poisoning in each age group. Results: A total of 27,472 patients visited an emergency department with poisoning during the study period; 1,958 patients who experienced unintentional poisoning were enrolled in this study. Respiratory medicine was the most frequent medicine in those younger than 15 years of age, and sedatives and antipsychotic drugs were the most common in patients older than 15 years of age. In total, 35.1% of patients older than 65 years were hospitalized. The most common reasons for poisoning were careless storage of medicine in those younger than 15 years of age and overdose due to arbitrary decisions in those older than 15 years of age. Conclusion: Unintentional medicine poisoning has distinct characteristics based on age group, and strategies to prevent poisoning should be approached differently based on age.
Kim, Myo-Jin;Bak, Joung-Hae;Seo, Won-Seok;Kim, Mi-Young;Park, Sun-Kyoung;Park, Jai-Soung
Quality Improvement in Health Care
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v.12
no.1
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pp.92-102
/
2006
Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxiety and fear of pediatric patients and their parents who do not have understanding logical of their disease and hospitalization. This study attempted to identify pain reduction in related to therapeutic intervention by age and environmental improvement. Methods : A total of 194 hospitalized children and their parents were investigated. Data collection period was 3 months from March to May 2004. Four instruments were used to collect the data : Faces Pain Rating Scale(FPRS), Heart rate, Oxygen saturation and Pain behavioral check list. The data were analyzed by a SPSS program and tested x2-test, t-test, ANCOVA. Results : 1. Age from 0 to 3, the Heart rate, FPRS, Oxygen saturation and Pain behavioral check list were significantly different in theraputic intervention group when compare to control group. 2. Age from 4 to 6, FPRS, Oxygen saturation and Pain behavioral check list were significantly different in theraputic intervention group when compare to control group. But the heart rate were not significantly different when compare to control group. 3. Age from 7 to 9, FPRS and Pain behavioral check list were significantly lower in therapeutic intervention group when compare to control group but Heart rate and Oxygen saturation were not significantly different when compare to control group. Conclusion : The results of this study concludes that most children experience acute pain during IV therapy and it can be reduced by age specific therapeutic intervention and by change of surrounding environment.
Journal of Physiology & Pathology in Korean Medicine
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v.25
no.4
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pp.734-742
/
2011
The purpose of this study was to investigate the distribution and correlation of stroke risk factor according to age with stroke patients. This study was based on clinical data registered in Daejeon Oriental Medical Hospital from November 2006 to December 2010. Study subjects consisted of 779 patients with stroke within 1 month and they were classified according to age and existence of past history such as hypertension, diabetes mellitus, ischemic heart diseaseand stroke family history. Stroke family history was distributed differently according to age unlike past history and in their 50's showed a particularly high rate. There was not statistically significant correlation between stroke family history and past history except for only between stroke family history and diabetes mellitus in the patients in their 80's and more. There was statistically significant correlation between hypertension and diabetes mellitus and especially in the patients in their 60's and 70's. There was statistically significant correlation between hypertension and ischemic heart disease and especially in the patients in their 80's and more. There was statistically significant correlation between diabetes mellitus and ischemic heart disease in the patients in their 60's. There was statistically significant correlation among hypertension, diabetes mellitus and ischemic heart disease, but stroke family history and past history had independence, so management and research for this subject should be required further and further.
Thirty-five cases of heart disease were operated on with cardiopulmonary bypass between November, 1980 and September, 1981. 1. There were 8 cases of congenital anomaly and 17 cases of acquired heart diseases. 2. There were 7 male and ] 8 female patients, with a mean age of 21 .9 years [range 7 to 42 years]. 3. There were 2 cases of valve replacement cases with operative mortality of 8.3%. 4. Operative mortality for congenital anomaly was ~ 6.7% and 5.9% for acquired heart diseases. 5. Over all operative mortality was 11.4%.
Purpose: This study was done to evaluate the incidence, type of injury, medical consequences, mortality, and prognostic factors associated with stab wounds in patients who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea. Methods: A retrospective analysis of the clinical data of 40 patients with abdominal stab wounds who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from January 1, 2000 to December 31, 2004. Results: 1) The most prevalent age group was patients in their the twenties to fourties (77.5% of all patients), and average age of the patients was 39.3 years. The male-to-female ratio was 2.07:1. 2) The external site of stab wounds was most commonly the periumbilcal area of the abdomen (14 cases, 33.3%). 3) The most commonly injured organs were the liver and the stomach (10 cases each, 16.9%). 4) Operations were performed on all 40 patients, with 9 (22.5%) negative operation findings. 5) Death occurred in 5 cases (12.5%). 6) The trauma indices of the death group were TRISS 51.9%, RTS 3.6 points, and APACHE II 23.0 points. 7) The average transfusion amount of the death group was 13.8 pints Conclusion: These data suggest that the transfusion amount and the trauma index of abdominal stab injuries may be statistically significant factors for predicting mortality.
Since we first performed open heart surgery on December 30, 1986, 126 cases were operated on up to August 31, 1989. Among the 126 cases, 65 cases were congenital heart disease of which 63 were acyanotic disease, and 61 cases were acquired heart disease, most of which were valvular heart disease. The age distribution of congenital heart disease was from 1 years 2 months to 48 years, and males had a slightly higher incidence. The age of acquired heart disease was from a minimum of 15 years to a maximum of 68 years, and the male to female ratio was 1;1.5. Midsternotomy was performed in all cases, and the aortic cannula was inserted through ascending aorta and the venous cannula inserted into the SVC and IVC through the right atrium. Vent was inserted through the right superior pulmonary vein. Cardioplegia solution was used in all cases; it was composed of sodium bicarbonate 3.5 ampule, KCL 14 mEq, 2% lidocaine 2.5 ml, 20 % albumin 50 ml and heparin 1000 units mixed to 950 ml with Hartman solution, and was made to 4oC and infused 10 ml per Kg every 20 minutes. The congenital heart disease had a variety of VSD in 32 cases, ASD 23 cases, PS 6 cases, PDA 2 cases, and one case each of Ebsteins anomaly and tricuspid atresia. The operations performed for acquired heart disease were 4 cases of OMC, 33 cases of MVR, and 5 cases of AVR, and 1 case of AVR with CABG. DVR was perfomed in 13 cases, and triple valve replacement was done in 1 case. Other than these, excision of LA myxoma was 2 cases, and repair of traumatic VSD and removal of a pulmonary embolism were one case each. The surgical mortality was 5 cases[4%], all of which occurred in valve replacement cases. Follow-up study revealed 2 late deaths. One died after a traffic accident and one died due to sepsis after he had received a gastrectomy for ulcer bleeding. The remaining patients were in good condition.
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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