• Journal of Chest Surgery
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• 제33권2호
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• pp.139-145
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• 2000

Background: The purpose of this study is to review the clinical course after the correction of noncomplicated ventricular septal defect and to analyze the morbidity and risk factors of postoperative complications and evaluate residual defect during the follow-up period. Material and Method: From September 1994 to June 1998 24 patients(median age 10 months) underwent surgery under the diagnosis of ventricular septal defect. We made a retrospective review of the clinical records including the operation notes critical care unit records echocardiography results and the follow-up records. Result: There was no early mortality nd late mortality. There was no postoperative complete conduction block. Respiratory complication was the most common complication. The body weight age type of ventricular septal defect associated anomalies and operative procedure were not related to the incidence of complications. residual ventricular septal defects aortic valve regurgitation and tricuspid valve regurgitation were insignificant in postoperative hemodynamics, Conclusions: Correction of the noncomplicated ventricular septal defect was done without mortality and complete heart block. Aggressive preoperative medical treatment and early surgical treatment may decrease postoperative complications. Postoperative residual shunt and tricuspid regurgitation were not problematic during the follow-up

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.451-459
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• 2021

Background: Lignocaine with adrenaline is routinely used as a local anesthetic for dental procedures. Adrenaline was added to increase the duration of anesthesia. However, epinephrine containing a local anesthetic solution is not recommended in conditions such as advanced cardiovascular diseases and hyperthyroidism. Recently, ropivacaine has gained popularity as a long-acting anesthetic with superior outcomes. The goal of this study was to assess and compare the effectiveness of 0.75% ropivacaine alone and 2% lignocaine with adrenaline (1:80,000) in the removal of bilateral maxillary wisdom teeth using the posterior superior alveolar nerve block technique. Methods: This was a single-blind, randomized, split-mouth, prospective study assessing 15 systemically sound outpatients who needed bilateral removal of maxillary third molars. We randomly allocated the sides and sequences of ropivacaine and lignocaine with adrenaline administration. We evaluated the efficacy of both anesthetics with regard to the onset of anesthesia, intensity of pain, variation in heart rate, and blood pressure. Results: The onset of anesthesia was faster with lignocaine (138 s) than with ropivacaine (168 s), with insignificant differences (p = 0.001). There was no need for additional local anesthetics in the ropivacaine group, while in the lignocaine with adrenaline group, 2 (13.3%) patients required additional anesthesia. Adequate intraoperative anesthesia was provided by ropivacaine and lignocaine solutions. No significant difference was observed in the perioperative variation in blood pressure and heart rate. Conclusion: Ropivacaine (0.75%) is a safe and an adrenaline-free local anesthetic option for posterior superior alveolar nerve block, which provides adequate intraoperative anesthesia and a stable hemodynamic profile for the removal of the maxillary third molar.

• Journal of Chest Surgery
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• 제31권10호
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• pp.1004-1008
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• 1998

본 논문은 동맥관개존증으로 인한 Eisenmenger 증후군 환자에서 시행된 심장-폐이식 수술에 대한 증례 보고이다. 동맥관 개존증으로 인한 Eisenmenger 증후군인 32세의 여자 수혜자는 1996년 6월 이후 심부전으로 심한 호흡곤란을 겪고 있었으며, 1997년 7월초에 빈맥, 호흡곤란, 하지부종을 주소로 응급실을 통하여 입원한 후 호흡곤란, 저산소증, 상심실성 빈맥, 전해질 이상 등으로 치료받으면서 퇴원하지 못하고 심장-폐 이식 대상자로 등록되었다. 수술전에 시행한 심초음파검사에서 우-좌단락의 동맥관개존증, 우심실 및 우심방의 심한 확장, 100 mmHg의 우심실 수축기압 소견을 보였다. 폐동맥압이 체동맥압보다 높게 역전되어 있었고 심한 이산화탄소 정체 및 저산소증의 소견을 보여서 중환자실에서 인공호흡기로 호흡기능을 보조받고 있었다. 공여자는 교통사고로 두부손상을 입고 뇌사판정을 받은 1 8세 남자였다. 공여자 및 수헤자의 혈액형은 모두 AB(+)형이었다. 1997년 10월 26일 심장-폐이식을 시행하였다. 심장 -폐분절은 공여자가 있던 타병원에서 구득하여 냉장보존 상태로 본원으로 이송하였다. 이식된 심장 및 폐의 총 허혈 시간은 각각 249분 및 270분이었다. 면역억제요법은 cyclosporine, azathioprine을 수술전부터 투여하였으며 steroid 는 기관 문합부위의 치유와 감염예방을 위하여 수술후 3주 이후부터 사용하였다. 환자는 수술후 31일째에 특별한 합 병증없이 퇴원하였으며 심장-폐이식후 4개월이 지난 현재, 심폐기능의 이상소견과 거부반응의 증거없이 NYHA funct ional class I의 상태로 지내고 있으며 면역억제제와 예방적 항생제, 소량의 이뇨제 및 항고혈압제를 복용하고 있다.

• Journal of Chest Surgery
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• 제28권3호
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• pp.233-236
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• 1995

Subepicardial space is one of the regions in which fat in moderate amount is normally deposited. When excess deposits of epicardial fat occur, penetration or infiltration of fat into the connective tissues between muscle bundles is observed. In some cases with very extensive involvement of epicardial fat,myocardial insufficiency and conduction system defect such as heart block have been implicated. More fat is deposited over the right ventricle than over left and the anterior surface contains more fat than dose the posterior surface. We studied 40 patients who underwent open heart surgery under the cardiopulmonary bypass. This study was designed to evaluate the percentage of the area of epicardial fat of the right ventricular anterior surface, which is more accessible area during the operative procedure. Other variables included thickness of subcutanous tissue of anterior chest wall, the ratio of waist to hip circumference, body weight and age. In conclusion, the amount of the epicardial fat correlates with thickness of the subcutaneous fat of the anterior chest wall and simple linear regression analysis indicates good correlation with body weight. Increased age results in large amount of epicardial fat.

• Journal of Chest Surgery
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• 제25권4호
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• pp.383-390
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• 1992

From Oct. 1983 to Dec. 1991, 135 cases of atrial septal defect which were operated at the department of Thoracic and Cardiovascualr Surgery, Chonnam National University Hospital, were analysed retrospectively. They were 23.7% of all congenital heart diseases operated in the same period. Among the 135 cases, 62 cases were male and 73 cases were female. Their ages were ranged from 2 to 54 years and the mean was 18 years old. Main symptoms at admission were exertional dyspnea[70.37%], frequent URI[49.12%] and palpitation[32.59%], but 12 cases[8.88%] were asymptomatic. Electrocardiographic findings wer regular sinus rhythm in 96.99%, RVH in 64.66%, incomplete RBBB in 27.06%, complete RBBB in 42.10%, and first degree AV block in 9.02% All 135 cases were operated under the direct vision with cardiopulmonary bypass. Anatomically, most frequent type was fossa ovalis defect with complete septal rim[78.52%]. 117 of 135 ASD patients were repaired with pathch closure[86.66%] and 14 patients were repaired with direct closure[10.37%] and 4 patients in mutiple ASD were repaired with patch and direct closure[2.96%]. Postoperative complications were occured in 21 cases[15.56%], and they were wound infection, pleural effusion, postoperative bleeding, urinary tract infection, and heart failure mainly. One case died due to epidural hematoma and operative mortality was 0.74%.

• Journal of Chest Surgery
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• 제17권2호
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• pp.244-249
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• 1984

Surgical treatment of partial endocardial cushion defect was accomplished in Feb. 1984 in this department. The 5 year old male patient had history of frequent upper respiratory tract infection and since his age of 3 years dyspnea on exertion and palpitation were noted but there were no cyanosis and clubbing. A thrill was palpable on the apex and grade IV/IV harsh systolic ejection murmur and diastolic murmur was audible on it. Liver was palpable about 3 finger breadths and no ascites. Chest X-ray revealed increased pulmonary vascularity, moderate cardiomegaly [C-T ratio; 0.69], and enlarged left atrium. EKG showed first degree heart block, RVH, LVH, and LAD. Echocardiogram showed paradoxical ventricular septal movement and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted left to right shunt [Qp:Qs:2.1:1 ] and moderate pulmonary hypertension [60/40 mmHg]. Left ventriculogram showed mitral regurgitation [Grade III/IV] and filling of left atrium and right atrium nearly same time. Operative findings were: 1.Primum type atrial septal defect [3x2 cm] 2.Cleft on the anterior leaflet of mitral valve. 3.No interventricular communication and cleft of tricuspid valve leaflet. The mitral cleft was repaired with 4 interrupted sutures. The primum type atrial septal defect was closed with Dacron patch intermittently at endocardial cushion and continuously remainder. The post operative course was uneventful and discharged on 22nd postoperative day in good general conditions.

• 대한한방내과학회지
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• 제11권2호
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• pp.137-147
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• 1990

I studied some important medical liter atures in order to examine the cause of Aphasia and found out some facts as follows : 1. Hwang Je Nae Kgong(黃帝內經) is more referred exogenous causes of disease of Aphasia than endogenous causes of disease. 2. Among many causes of Aphasia, exogenous causes of disease was cinsidered to be most common in Soh Shi Je Byong Won Hu chong Rhon(巢氏諸病源喉總論), which has had a wide influence down the ages. 3. Chon Keum Yo Bang(千金要方), Chi Tae Bhi Yo(外臺秘要), Tae Pyong Song Hye Bang(太平聖惠方), Song Je Chong Rok(聖濟總綠). Bu In Yang Bang(婦人良方) and so forth had been quoted from Hwang Je Nae Kyong and Soh Shi Je Byong Won Hu Chong Ron(巢氏諸病源喉總論). 4. In the ming dynasty had been quoted non-exo-endogenous causes of disease and the Kinds of Aphasia and prescription. 5. In the Choeun dynasty and the Ching dynasty, exogenous causes of disease was confined to the quotation of the books referred to above as well, but endogenous causes of disease was developed. 6. Today is refered kidney and Aphasia. The cause of Aphasia obtained was as follows. The exogenous cause of disease is wind, wind and cold, wind and heat. The endogenous cause of disease is pregnancy, heart block of postpartum, weakness of heart and kidney, impairment of seven modes of emotions, stagnation of phlegm and phlegm-fire, hemorrhage. The non exo-endogenous causes of disease is sing ballads and call out.

• 사상체질의학회지
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• 제15권3호
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• pp.147-157
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• 2003

The purpose of this study is to examine the effects of Sasang constitutional herbal extracts, Cheongsimyeonjatang(CYT) on ECG(electrocardiogram). For this purpose, Ten hospitalized Taeumin patients were selected and changes of the ECG was investigated. The researcher also measured and observed ECG changes before and after CYT medication. The following is the summarized results of study. 1. The RV5+SV1 voltage was decreased in LVH patients. 2. The S-T voltage was decrease in the previous S-T elevated patients. 3. The heart rate was increased in the patients of lower heart rate than normal. 4. There was no remarkable change after medication on T-inversion and bundle branch block. From the above results, it is concluded that Cheongsimyeonjatang(CYT) have influenced on ECG.

• 한국임상수의학회지
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• 제27권4호
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• pp.435-439
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• 2010

6살된 암컷 불테리어종 개 (체중 17 kg)가 운동 불내성과 실신증상으로 내원하였다. 진단검사를 통해 특발성 심근확장증에 의한 심방조동과 완전 방실차단 증례로 진단되었다. 환자는 심근증에 대한 일반적인 치료와 dofetilide를 포함한 항부정맥 치료를 통해 11개월간 관리되었다. 하지만 환자는 갑작스런 심장마비로 폐사하였다.

• 대한간호학회지
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• 제38권6호
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• pp.802-812
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• 2008

Purpose: The purpose of this study was to identify and describe phenomenological structures of the lived experience of struggling against an illness for patients with Amyotrophic Lateral Sclerosis (ALS). Methods: The participants were 7 patients with ALS recruited by snowball sampling who agreed to participate in this research and could verbally communicated with the researcher. Data were collected by long term-repeated interviews with participants in their own homes. Data were analyzed using Colaizzi's method of phenomenology. Results: Four categories were extracted as follows: 'Being seized with fear of death', 'Living a marginal life', 'Accepting hard fate', and 'Clinging to faint life'. Seven theme clusters were identified as: 'Wandering to find a healing method with ominous signs in the body', 'Having a diagnosis of ALS is like a bolt from the blue and struggling against illness with faint hope', 'Being forced out to the edge of life with anguish', 'Filling one's heart with hatred and longing toward becoming estranged from the world', 'Living with stigma as a stumbling block with bitter grief in one's heart', 'Accepting every things as one's fate with self controlled fear of death', and 'Attaching to desire to live'. Conclusion: The results of this study can be used to develop the programs to support patients with ALS and their family.