• 한국임상수의학회지
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• 제28권1호
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• pp.133-138
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• 2011

A 4-year-old female Fox Terrier dog (weighting 8 kg) with history of severe abdominal distention and anorexia was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, grade 4/6 systolic murmur heard at the left heart base. Electrocardiography showed right ventricular enlargement (right axis deviation and deep S wave) and right atrial enlargement (P pulmonale). Diagnostic imaging studies revealed hypertrophy of right ventricle, enlargement of right atrium and tricuspid regurgitation and turbulence in the pulmonary artery in right parastenal short axis view. Based on the diagnostic findings, the dog was diagnosed as a case of valvular pulmonic stenosis.

• Journal of Chest Surgery
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• 제28권6호
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• pp.601-605
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• 1995

Clinical evaluations were performed on 54 cases of the traumatic sternal fracture, those were admitted and treated at the department of Thoracic and Cardiovascular Surgery in Chosun University Hospital during the past 5 years period from January 1990 to December 1994. The frequency was about 7.8% of the nonpenetrating chest trauma. The ratio of male to female was 2 : 1 in male predominance. Average age was 45.7 years old and age distribution was from 18 to 80 years old. The most common cause in the sternal fracture were high decelerating injury[ 38 cases . The most common fracture site was sternal body. Associated intrathoracic organ injuries were cardiac contusion[11cases , hemopneumothorax and pulmonary contusion. Added, thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture and long bone fracture. Abnormal ECG findings were sinus bradycardia[4 cases , sinus tachycardia[3 cases , bundle branch block, atrial fibrillaton, left ventricular hypertrophy and myocardial ischemia. The average days of admission was 19.1 days. All patients were treated with conservative treatment. The complications after treatment were atelectasis[2 cases ,empyema[1 cases , ARDS[1 cases .

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.84-87
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• 2016

Midaortic syndrome (MAS) is a rare vascular disease that commonly causes renovascular hypertension. The lumen of the abdominal aorta narrows and the ostia of the branches show stenosis. MAS is associated with diminished pulses in the lower extremities compared with the upper extremities, severe hypertension with higher blood pressure in the upper rather than lower extremities, and an abdominal bruit. The clinical symptoms are variable, and recognition in children with hypertension can aid early diagnosis and optimal treatment. Hypertension with MAS is malignant and often refractory to several antihypertensive drugs. Recently, radiologic modalities have been developed and have led to numerous interventional procedures. We describe the case of a 3-year-old boy presenting with left ventricular hypertrophy whose severely elevated blood pressure led to the diagnosis of idiopathic MAS. This case highlights the importance of measuring blood pressure and conducting a detailed physical examination to diagnose MAS. This is the first reported case of idiopathic MAS diagnosed in childhood in Korea.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.7-12
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• 2014

만성 콩팥병의 장기 예후를 결정하는 요인 중 심혈관계 합병증의 중요성은 잘 알려져 있다. 그러나 소아 환자의 경우 전형적인 증상 발현이 적어 그 임상적 중요성이 간과되는 경향이 있다. 현재까지 알려진 심혈관계 합병증의 위험인자로는 고혈압, 당뇨병, 이상지질혈증, 비만과 같은 전통적인 위험 인자와 빈혈, 이차성 부갑상선 기능항진증, 산화 스트레스, 염증과 같은 새로운 위험 인자 등이 알려져 있다. 소아 만성 콩팥병의 경우 주로 좌심실 비대나 경동맥 내중막 두께의 증가 및 관상동맥의 석회화 같이 대부분 겉으로 드러나지 않는 증상이므로 위험 인자에 대한 철저한 관리와 지속적인 추적 관찰이 필수적이다.

• Journal of Chest Surgery
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• 제19권1호
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• pp.43-49
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• 1986

At the Department of Thoracic and Cardiovascular Surgery, Hanyang university, from 1976 to 1984, 102 patients operated for isolated patent ductus arteriosus were studied. The correlation between the degree of left ventricular hypertrophy [LVH] and hemodynamic data, and postoperative changes of electrocardiographic findings were evaluated. The following results were obtained; [1] Of 102 patients with isolated patent ductus arteriosus, 78 patients [76.5%] were found to have LVH by EKG, preoperatively. [2] The patients with LVH had higher incidence of respiratory infection [79.4%] compared to patients without LVH. [3] Frequent physical findings in the patients with LVH were precordial bulging and P2 accentuation on auscultation. The typical continuous machinery murmur was not different in two group with or without LVH. [4] 66.1% of patients with LVH showed more than 56% of cardiothoracic ratio [CTR] on simple chest X-ray. 56.5% of patients without LVH showed less than 50% of CTR. [5] In the patients found to have LVH by EKG, the correlation between values of Svl+Rv6 and Qp/Qs in hemodynamic data was correlation coefficient 0.57 and between CTR and Qp/Qs was correlation coefficient 0.51. [6] In patent ductus arteriosus with LVH following surgery, the values of Svl+Rv6 was changed from preoperative 153.6$\pm$42.78% to 107.7$\pm$19.58% within 3 months and to 80.4$\pm$12.22%, which is within normal range of Svl+Rv6 on EKC, after 6 months.

• 한국임상수의학회지
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• 제38권4호
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• pp.189-193
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• 2021

An 11-years old spayed female Persian chinchilla cat presented with acute onset of blindness from bilateral retinal detachment and systemic hypertension. On physical examination, the cat was tachycardic (240 beats/min) with a systolic blood pressure of around 250 mmHg. Clinical findings, blood works, urinalysis, thyroid function test, radiography, echocardiogram, and ultrasonography were performed to rule out underlying diseases. Organ injury induced by systemic hypertension including bilateral retinal detachment and left ventricular hypertrophy were confirmed by ultrasound. Based on these results, it was diagnosed as feline idiopathic hypertension with target organ damage (TOD). The cat was treated with a combination therapy using high doses of amlodipine, telmisartan, and atenolol. After the treatment, its hypertension and TOD were improved. This case showed that appropriate therapeutic management can help prevent TOD associated with feline hypertension.

• 한국임상수의학회지
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• 제31권4호
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• pp.298-302
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• 2014

8년령의 중성화된 잡종 수컷 고양이 (증례 1)와 3년령의 중성화된 샴 수컷 고양이 (증례 2)가 뒷다리 마비, 지속적인 개구호흡, 그리고 객혈 등을 주증으로 내원하였다. 심잡음 (증례 1)과 분마성심음 (증례 2)이 좌측 심저부에서 청진되었으며, 방사선 검사상 증례 1의 경우 폐포패턴을 동반한 심한 공기연하증이, 증례 2에서는 확연한 심비대가 확인되었다. 심초음파 검사에서 두 마리 고양이 모두에서 좌심실과 심실중격의 구심성 비대와 좌심방의 확장이 확인되었다. 심장 초음파를 포함한 검사를 바탕으로 본 환축은 고양이 심근비대증으로 진단되었으며, 신체검사와 복부 초음파 검사를 통하여 병발한 안장색전증을 확인하였다. 일반적인 치료를 통한 환축의 예후가 불량한 점을 감안하여, 직접적인 혈관내 혈전용해술이 시도되었다. 혈관조영술을 통하여 혈전의 위치와 크기를 확인 할 수 있었으나, 광범위한 색전증으로 인하여 중재적 시술을 이용한 혈전용해는 성공적이지 못했다.

• 대한임상검사과학회지
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• 제44권3호
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• pp.136-141
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• 2012

The hearts of highly trained athletes show morphologic and electrocardiographic (ECG) changes that suggest the presence of cardiovascular disease, including sinus bradycardia, a striking increase in precordial R-wave or S-wave voltages, ST segment depression, and T-wave inversions. Despite a number of previous observational surveys, the determinants of abnormal ECG patterns in trained athletes remain largely unresolved. In this study, we compared the electrocardiographic characteristics of athletes to determine any sensitive indicators. Comparison between ECG patterns and cardiac physiology was performed in 21 junior athletes and 25 untrained subjects with no signs of cardiac disease. Sinus bradycardia was detected in a subset of athletes but not statistically significant between the athletes ($69.9{\pm}11.1bpm$) and the control ($72.7{\pm}9.9bpm$) group. The mean values of the PR and QTc intervals in the athletes' group were $149.2{\pm}15.4ms$ and $402.3{\pm}28.8ms$, respectively. Also, there were no significantly differences between control group and the athletes' group. In addition, the athletes demonstrated a spectrum of alterations in the 12-lead ECG pattern, including marked increase in precordial R-wave or S-wave voltages ($$SV_1+RV_5{\geq_-}35mm$$, 23.8%), QRS duration ($${\geq_-}90ms$$, 90.5%), suggestive of left ventricular hypertrophy. However, left axis deviation, ST segment depression, and T-wave changes in V5, V6 were not observed in either the athletes or control group. Our findings suggest that sinus bradycardia, precordial R-wave or S-wave voltages, and QRS duration seem to be more sensitively detected in athletes than in control group. Further researches on the electrocardiographic patterns of athletes should be carried out to improve the sensitivity and specificity of diagnostic criteria.

• Journal of Chest Surgery
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• 제5권1호
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• Journal of Chest Surgery
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• 제36권9호
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• pp.651-658
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• 2003

On-X 기계판막은 1997년 처음으로 사용된 이후 전 세계적으로 사용빈도가 증가하고 있다. 본 연구는 이 새로운 기계판막에 대한 유용성과 안전성, 그리고 술 후 혈역학적 변화에 대해 알아보고자 시행되었다. 대상 및 방법: 1999년 4월부터 2002년 8월까지 전남대학교병원 흉부외과에서 On-X 판막을 사용하여 대동맥판막 치환술을 시행했던 52명의 환자를 대상으로 분석하였다. 환자 중 52%가 남자였으며 평균연령은 50$\pm$13세였다. 연구는 판막수술 후 결과보고에 대한 AATS/STS 지침에 따라 분석하였다. 술 전 뉴욕 심장병학회의 기능분류상 class III 이상의 환자가 32명(61.5%)이였으며, 2명의 환자는 이전에 대동맥판막 수술을 받았던 환자였다. 71.1%의 환자에서 동반된 질환에 의해 대동맥판막 치환술과 함께 동반 수술을 시행하였고, 이식된 판막의 크기는 19 mm 13명, 21 mm 26명, 23 mm 10명과 25 mm 3명이었다 평균 외래 추적관찰 기간은 16.6$\pm$10.5 (1∼39)개월이었다. 수술 전과 수술 직후 그리고 3, 6, 12개월에 심초음파를 반복 시행하여 술 후 혈역학적 변화양상을 분석하였다. 결과: 평균 체외순환시간과 대동맥 차단시간은 각각 191$\pm$94.7분과 142$\pm$51.7분이었다. 술 후 조기 및 만기 사망은 없었다. 술 후 12개월간 event-free rate는 혈전색전증 95.6$\pm$6%; 출혈성 합병증 90.2$\pm$4%: 판막 주위누출 92.3$\pm$4%이었으며 전체적인 event-free rate는 76.6$\pm$3%이었다. 수술 후 판막혈전이나 심내막염, 구조적 판막부전은 발생하지 않았다. 술 후 12개월의 평균심박출량은 62.7$\pm$9.8%로 수술 전(55.8$\pm$15.9%)에 비해 의미 있는 증가를 보였다(p=0.006). 좌심실 체적지수와 최대 판막압력차는 수술 전에 247.3$\pm$122.3 g/$\textrm{cm}^2$, 62.5$\pm$38.0 mmHg을 보였으나 술 후 12개월에 각각 155.5$\pm$58.2 g/$\textrm{cm}^2$(p=0.002), 18.0$\pm$10.8 mmHg (p<0.0001)로 감소하는 소견을 보였다. 결론: On-X 기계판막을 이용한 대동맥판막 치환술은 임상적 및 혈역학적으로 만족스러운 조기 결과를 보여주었다. 그러나 대상 환자들에 대한 장기간의 외래 추적관찰과 함께 기존 판막과의 비교가 이루어짐으로써 이 새로운 판막에 대한 유용성과 안정성이 확립될 수 있을 것으로 생각한다.