• Korean System Dynamics Review
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• v.15 no.4
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• pp.61-84
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• 2014

This study aims to explore the development and application of a simulated skills package designed to improve nursing students' knowledge integration and their system thinking(ST) skills about congestive heart failure(CHF) and to identify the change in students' ST levels using a ST-based learning approach. A simulated learning support package was developed by nurse educators and ST experts. The developed program was implemented with 35 third-year nursing students from S university in Seoul. The subjects improved their ST skills regarding CHF after intervention. Mean test scores for students completing the program were significantly higher than pre-intervention scores, including measures of direction of causality, polarity of causal relationship, feedback loop, polarity of feedback loop (reinforcing, balancing) and time delay (t=2.26~6.53, p=.030~p<.001). It is suggested that more educational programs be developed on various topics in order for nursing students to improve their ST skills as well as knowledge integration in clinical nursing practicum packages.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.121-130
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• 1988

During one year period from Sep. 1986 to Sep. 1987, we have experienced 6 cases of infective endocarditis requiring surgical interventions. All 6 patients had class IV or V cardiac disability at the time of surgery. The indication for surgery was rapidly progressive congestive heart failure in all cases. Four patients underwent aortic valve replacement including one double valve replacement. Two other patients required other surgical procedures, removal of large left atrial vegetation mass in one patient and excision of destroyed pulmonary valve and aortic vegetation in the other patient. Two patients died; one of mitral annulus rupture after release of aortic clamp and the other of mediastinal bleeding 3 months after replacement of aortic valve. Three out of 4 survivors are in NYHA Class I and the remaining patient is in Class II. We emphasize that early operative intervention is life-saving in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy.

• Korean Journal of Radiology
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• v.2 no.4
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• pp.235-238
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• 2001

Phlegmonous enteritis is a rare infective inflammatory disease of the intestine, predominantly involving the submucosal layer. It is difficult to diagnose and often fatal. Its association with alcoholism and various liver diseases, although rarely reported, is well documented. We report a case of phlegmonous enteritis in a male patient with congestive heart failure and colon cancer, and describe the ultrasonographic and CT findings.

• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.5-8
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• 2015

D-dimer is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. D-dimer concentration is widely used for determining thrombosis and thromboembolism. Because one major cause of thromboembolism is congestive heart failure in human, we investigated the degree and risk of thromboembolism in dogs with different stage of congestive heart failure caused by chronic mitral valvular insufficiency (CMVI). The plasma level of d-dimer was evaluated in 20 healthy dogs and 30 dogs with different stage of congestive heart failure caused by CMVI. The d-dimer concentrations were measured by a commercialized assay kit. The plasma levels of d-dimer were not significantly different between healthy and CMVI dogs. Furthermore, there was no association of d-dimer concentrations to left atrium to aorta (LA/Ao) ratio, left ventricular dimension at diastole to aorta (LVIDd/Ao) ratio and severity of heart failure in our study population. Our study results implied that the degree of thromboembolism in canine heart failure might be minimal or the plasma d-dimer test might not be reliable for detecting thromboembolism in dogs.

• Clinical and Experimental Pediatrics
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• v.54 no.6
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• pp.260-266
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• 2011

Purpose: Infantile hepatic hemangioendothelioma (IHHE) is the most common type of hepatic vascular tumor in infancy. We conducted this study to review our clinical experience of patients with IHHE and to suggest management strategies. Methods: We retrospectively analyzed the medical records of 23 IHHE patients (10 males, 13 females) treated at the Asan Medical Center between 1996 and 2009. Results: Median age at diagnosis was 38 days (range, 1 to 381 days). Seven patients (30%) were diagnosed with IHHE based on sonographically detected fetal liver masses, 5 (22%) were diagnosed incidentally in the absence of symptoms, 5 (22%) had congestive heart failure, 3 (13%) had skin hemangiomas, 2 (9%) had abnormal liver function tests, and 1 (4%) had hepatomegaly. All diagnoses were based on imaging results, and were confirmed in three patients by histopathology analysis. Six patients were observed without receiving any treatment, whereas 12 received corticosteroids and/or interferonalpha. One patient with congestive heart failure and a resectable unilobar tumor underwent surgical resection. Three patients with congestive heart failure and unresectable tumors were managed by hepatic artery embolization with/without medical treatment. At a median follow-up of 29 months (range, 1 to 156 months), 21 (91%) patients showed complete tumor disappearance or >50% decrease in tumor size. One patient died due to tumor-related causes. Conclusion: IHHE generally has a benign clinical course with low morbidity and mortality rates. Clinical course and treatment outcome did not differ significantly between medically treated and non-treated groups. Surgically unresectable patients with significant symptoms may be treated medically or with hepatic artery embolization.

• Korean Journal of Veterinary Service
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• v.46 no.3
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• pp.181-192
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• 2023

Cystatin C, a low-molecular-weight protein synthesized by cells, is being explored as a valuable biomarker for assessing renal function in veterinary medicine. Although the relationship between cystatin C and heart disease remains unclear, some studies suggest a possible association. This retrospective case-control study aimed to investigate the role of cystatin C as a biomarker for heart disease and its correlation with diuretic use in veterinary clinical practice. A total of 39 dogs were included in this study, comprising 9 control dogs without a predisposition to heart disease and 30 dogs in the study group diagnosed with heart disease. Among the 30 dogs with heart disease, 18 exhibited symptoms indicative of heart failure. Results showed significantly higher cystatin C levels in the heart disease group compared to the control group (P<0.05). However, no significant differences were observed among different stages of heart disease severity in the control group. Furthermore, cystatin-C showed statistically positive correlations with BUN (r=0.478, P<0.01), creatinine (r=0.506, P<0.01), and furosemide (r=0.338, P<0.05). Diuretics are essential for managing congestive heart failure, and the observed associations between cystatin C and furosemide suggest potential impacts of diuretic use on renal function in dogs with heart failure. Monitoring renal function markers, such as cystatin C, can aid in predicting and managing potential renal complications, ultimately improving the overall health and quality of life of dogs with heart disease.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.752-759
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• 1995

Background: Bronchial asthma is characterized by noctunal dyspnea, cough and wheezing because of airway hyperresponsiveness to nonspecific stimuli. These symptoms and signs are also observed in patients with congestive heart failure. Therefore, this is so called "cardiac asthma". There are lots of experimental and clinical datas to suggest that airway dysfunctions occur in acute and chronic congestive heart failure. However, it is still controversial whether bronchial hyperresponsiveness is present in patients with congestive heart failure. To assess whether bronchial hyperresponsiveness is present in patients with congestive heart failure and to demonstrate the relationship between bronchial responsiveness and vascular pressure, we performed methacholine provocation test in 11 patients with mitral valvular heart disease. Methods: All patients were in the New York Heart Association functional class II and treated continuously with digoxin and/or dichlozid and/or angiotensin converting enzyme inhibitor except one patient. All patients were undergone right and left side heart catheterization for hemodynamic measurements. A 20 percent fall of peak expiratory flow rate were considered as positive response to methacholine provocation test. Results: 1) Only one patient who has normal pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index was positive in methacholine provocation test. 2) Their mean pulmonary artery pressure, pulmonary capillary wedge pressure were $21.72{\pm}9.70mmHg$, $15.45{\pm}8.69mmHg$ respectively which were significantly higher. Conclusion: It is speculated that in stable congestive heart failure patients, bronchial responsiveness as assessed by methacholine provocation test may not be increased.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.310-312
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• 1994

Primary cardiac lipoma is an extremely rare condition. We reports a case of primary lipoma located mainly in the right atrium of the heart in a 58-year-old male patient. The initial presenting symptoms were dyspnea followed by rapidly progress!ve congestive heart failure. Echocardiogram revealed huge mass on right atrium with stalk arising from septum. Under cardiopulmonary bypass the mass was removed and revealed characteristic findings of lipoma on microscope. The patient was recovered without any problem. We would like to describe this case of rare tumor with the review of literatures.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.32-41
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• 1989

We scrutinized the 64 cases of TGA and Taussig-Bing anomaly who underwent Senning and Mustard operations from Jan. 1981 to May 1988. The ratio of male to female was 45; 19, and the age at operation varied from 2 months to 18 years [mean 18.9*32.9 months]. The in-hospital mortality was in 24 cases [37.5%] and the major causes were myocardial failure and congestive heart failure associated with arrhythmias. The risk factors for hospital mortality were complex TGA, prolonged bypass time and high postoperative CVP. In addition, mortality increased during the first year the procedure was used. Late mortality occurred in 6 cases and the major causes was congestive heart failure, and there was not any significant risk factor noted in late mortality. Early arrhythmia developed in 37.5%, all of which were transient and self limited and 7 cases of early mortality were related to the arrhythmias. Late arrhythmias developed in 8 cases, but 7 cases were transient. One case died with junctional tachycardia. Of significance the one case that died late by arrhythmia had a similar junctional tachycardia in the early postoperative period. The survival rate in all cases disregarding initial in-hospital mortality 1YSR 89.8% and 5YSR 84.3%, but because of short duration of follow up this is not significant. We concluded that early hospital mortality could be decreased by operating at an earlier age and by adjusting the appropriate operation method.

• Proceedings of the Korean Society of Toxicology Conference
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• 2001.10a
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• pp.20-21
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• 2001

Free radicals and oxidative stress playa crucial role in the pathophysiology of a broad spectrum of cardiovascular diseases including congestive heart failure, valvular heart disease, cardiomyopathy, hypertrophy, atherosclerosis and ischemic heart disease. We have demonstrated that IH 636 proanthocyanidin extract (GSPE) provides excellent protection against free radicals in both in vitro and in vivo models, and exhibits significantly better efficacy as compared to vitamins C, E and $\beta$-carotene.(omitted)