• Title/Summary/Keyword: Left atria

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Double-outlet Right Ventricle with Pulmonary Stenosis [DORV: S.D.D.,subaortic VSD with ps]: One Operative case Report (양대혈관 우심실 기시증: 폐동맥협착 동반례의 수술 치험)

  • Kim, Hyeong-Muk;Lee, Nam-Su;Song, Yo-Jun
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.148-155
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    • 1977
  • The clinical findings with cardioangiography and successful surgical treatment of a 10 year old girl with double-outlet right ventricle is reported at The Dept. of Thoracic and Cardiovascular Surgery, Korea University Hospital, College of Medicine. The patient has been suffered from intermittent cyanosis, palpitation, and exertional dyspnea since 1 year after NFSD, and a holosystolic ejection murmur of grade 4 at the left 3rd intercostal space with mild cyanosis of the lips was the only physical findings at the time of this admission. Cardiac catheterization revealed ventricular septal defect with left to right shunt of 43% and right to left shunt of 10.2%. On cardioangiography from the left ventricle revealed all of the left ventricular outflow shunted into the right ventricle through the large ventricular septal defect, and the aorta originated from the infundibular chamber of the right ventricle with left, anterior sided pulmonary artery. The atria, viscera, and ventricles were normally located, and right ventricular out-flow was narrowed with infundibular hypertrophy and pulmonary valvular stenosis. Surgical correction was accomplished by closure of the ventricular septal defect in such a way that left ventricular outflow was routed via a Teflon felt prosthetic tunnel to the aorta, and pulmonary valvulotomy with infundibulectomy Was done to pass Hegar`s dilator No. 15 for reconstruction of the right ventricular outflow tract. The patient tolerated complete repair and has continued to improve over a period of three months after operation with normal school life. Details of the disease and method of repair are presented with related references.

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Low Cardiac Output after Division of the Left Superior Vena Cava during a Norwood Operation for Hypoplastic Left Heart Syndrome in a Patient with Coronary Sinus Orifice Atresia -A case report- (관상정맥동 유입부 폐쇄를 동반한 좌심형성부전 증후군 환자의 Norwood 수술 중 좌상대정맥 절단 후 발생한 저박출증 - 1예 보고 -)

  • Choi, Eun-Seok;Kim, Woong-Han;Park, Sung-Joon;Kwak, Jae-Gun;Seo, Jeong-Wook
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.161-163
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    • 2010
  • A 12-day-old female baby underwent a Norwood procedure for hypoplastic left heart syndrome. The left superior vena cava (LSVC), which was found incidentally during the operation, was divided to facilitate surgical exposure. After the operation, she developed signs of low cardiac output and died 7 hours afterward. Autopsy findings showed that the coronary sinus was atretic at the orifice without unroofing into both atria, rendering the LSVC the sole route of coronary sinus drainage. In patients with incidentally-found LSVC during surgery, special care should be taken to leave the LSVC intact because the LSVC may be the exclusive drainage vein of the coronary venous system.

Recent Advances in Surgery for Atrial Fibrillation (심방세동의 최신 외과적 치료)

  • Lee, Dong-Hyup;Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.13-26
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    • 2005
  • Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.

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Treatment results of cardiac tamponade due to thoracic trauma at Jeju Regional Trauma Center, Korea: a case series

  • Jeong Woo Oh;Minjeong Chae
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.180-186
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    • 2023
  • Purpose: The purpose of this study was to report the treatment results of patients with traumatic cardiac tamponade after the opening of Jeju Regional Trauma Center. Methods: We analyzed the treatment outcomes of patients with traumatic cardiac tamponade who were treated at Jeju Regional Trauma Center from January 2018 to August 2022. Results: Seven patients with traumatic cardiac tamponade were treated. The male to female ratio was 1.33:1 (four male and three female patients) and the average age was 60.3±7.2 years. The mechanism of injury was blunt trauma in six cases and penetrating injury in one case. Upon arrival at the emergency department, pericardiostomy was performed in four cases, and an emergency operation was performed in six cases. Pericardiostomy alone was performed in one patient, who had cardiac tamponade due to extrapericardial suprahepatic inferior vena cava rupture. The causes of cardiac tamponade were right atrium appendage rupture in one case, right ventricle rupture in one case, inferior vena cava rupture in two cases, right atrium and left atrium rupture in one case, both atria and left ventricle rupture in one case, and intercostal artery rupture in one case. In three cases, intraoperative cardiopulmonary bypass was required. Two of the seven patients died (mortality rate, 28.5%). Conclusions: Relatively favorable treatment results were observed for traumatic cardiac tamponade patients after Jeju Regional Trauma Center was established.

A Primary Neuroendocrine Tumor Mimicking a Thrombus in the Left Atrial Appendage (좌심방이에서 발생한 혈전을 모방한 심장의 일차성 신경 내분비 종양)

  • Myoung Kyoung Kim;Sung Mok Kim;Eun Kyoung Kim;Dong Seop Jeong;Yeon Hyeon Choe
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.444-449
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    • 2022
  • Most cardiac tumors are metastases, and primary cardiac tumors are rare; even among primary cardiac tumors, primary cardiac neuroendocrine tumors (NETs) are extremely rare. Herein, we report a case of a patient presenting a left atrial mass without past medical history. Because of the location and movement of the mass, as well as the patient's cerebral infarction episode, the mass was initially suspected to be a thrombus. However, the mass was surgically diagnosed as NET.

Studies on the Regulation of Calcium Activity in Myocardial Contraction (심근 수축에 있어서 Calcium작용의 조절에 관한 연구)

  • Ko, Chang-Mann;Hong, Sa-Suk
    • The Korean Journal of Pharmacology
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    • v.26 no.2
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    • pp.113-120
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    • 1990
  • Influences of trigger calcium on myocardial contraction from several sources were investigated on the frequency reduction-induced changes of contraction in rat left atria driven by electrical field stimulation. Rat atria elicited characteristic three phase-changes according to frequency reduction: the first rapid rise in twitch tension, the second transient fast decrease in tension and the third maintenance of twitch tension at about 200% of resting tension during high frequency. Caffeine treatment enormously suppressed the frequency reduction-induced twitch tension increase. The atrial contraction during high frequency vanished after verapamil treatment. But, during low frequency, atrial contraction revived in the presence of verapamil. Ouabain treatment and sodium depletion in superfusing solution abolished the characteristic second phase with slow frequency. These results suggest that slow calcium channel is an indispensable calcium entry route and calcium release from sarcoplasmic reticulum is an major source for trigger calcium in cardiac contraction. And sodium-calcium exchange has a modulatory roles in the regualtion of trigger calcium according to the changes of intracellular sodium concentration.

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Isolation of Flavone Glycoside from Circium japonicum var ussuriense and Biological Activity on the Cardiovascular System (엉겅퀴 지상부의 심혈관 작용활성 및 후라본 배당체의 분리)

  • Lim, Sang-Sun;Lee, Jong-Ho;Park, Jong-Cheol
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.26 no.2
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    • pp.242-247
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    • 1997
  • A flavone glycoside was separated from the aerial part of Circium japonicum var ussuriense Kitamura and the effect on cardiovascular system was investigated. The cadiovascular contractility of this compound was observed in the artria and aortae from normal rats. It increased the spontancous beat in right atria and the contractile force in left atria, and caused the contraction of thoracic aortae. For the blood pressure, it had ascending effect. The effective component, which acted on stimulation and contraction in the artria and aortae of rats was fractionated with n-BuOH, separated and identified by column chromatography, UV, IR, $^1H-NMR$ and $^{13}C-NMR$. The chemical structure for this component was determined to be $hispidulin-7-{\alpha}-rhamnopyranosyl(1{\rightarrow}2)-{\beta}-D-glucopyranoside$.

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The Pharmacological Studies on the Origin of Calcium ion in Myocardial Contraction (심근 수축에 있어서 Calcium 이온의 기원에 관한 약리학적 연구)

  • Ko, Chang-Mann;Kim, Kyung-Hwan
    • The Korean Journal of Pharmacology
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    • v.30 no.1
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    • pp.67-73
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    • 1994
  • Na-Ca exchange transports calcium ion either into (reverse mode Na-Ca exchange) or out of the cell (forward mode Na-Ca exchange) according to the direction of driving force produced by the changes in ratio of intra- and extra-cellular Na concentrations. Thus, Na-Ca exchange is regarded as the regulator of myocardial contraction. However, the existence of reverse mode Na-Ca exchange and its role in myocardial contraction is still questioned. Present study was performed to identify the presence of reverse mode Na-Ca exchange and its possible involvement in the regulation of myocardial contraction in rat heart. Using the left atria of rat, contraction was induced by electrical field stimulation (EFS, 0.5 msec duration and supramaximal voltage). Changing of the stimulation frequencies from resting 4 Hz to 0.4, 1 or 8 Hz caused typical negative staircase effect in twitch tension, but $^{45}Ca$ uptake showed bimodal increase. When the stimulation frequency was abruptly changed from 4 Hz to 0.4 Hz the atrial twitch tension showed three phased-enhancement, that is, the initial rapid increase (the first phase) followed by rapid decrease (the second phase) and stabilization (the third phase). $^{45}Ca$ uptake was equivalent to tension, i.e. initial significant increase in first 30 second and then decrease. Benzamil treatment abolished the first phase of increase in a dose dependent manner from $10^{-5}\;to\;3{\times}10^{-4}M.$ Bay k 8644 $(3{\times}10^{-5}M)$ treatment enhanced the inotropy induced by frequency reduction and abolished the second and third phase decreases. Benzamil treatment also suppressed the contraction stimulated by Bay K 8644. Although the contraction at 4 Hz stimulation was completely abolished by verapamil $3{\times}10^{-5}\;M$ pretreatment, the contraction reappeared as soon as the stimulation frequency was changed into 0.4 or 1 Hz and interstingly,$^{45}Ca$ uptake were significantly higher than no treatment. From these results, it is concluded that reduction of stimulation frequency causes calcium influx by the reverse mode Na-Ca exchange, resulting in initial rapid increase of twitch tension. then it turns into forward mode exchange to efflux the calcium, resulting in decrease of the twitch tension in left atria of rat.

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Optimal Cardiac Magnetic Resonance Contrast-Enhanced Timing Robust Angiography (CMR-CENTRA) for the Three-Dimensional Reconstruction of the Bilateral Atria in the Electroanatomic Mapping (EAM) of Atrial Fibrillation

  • Kim, Jun Seong;Oh, Yu-Whan;Shim, Jaemin;Kim, Young-Hoon;Hwang, Sung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.131-138
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    • 2017
  • Purpose: To optimize the timing of scans using cardiac magnetic resonance contrast-enhanced timing robust angiography (CMR-CENTRA) for electroanatomic mapping (EAM) of the right atrium (RA) and left atrium (LA) in patients with atrial fibrillation (AF). Materials and Methods: Fifty patients with AF (38 men; mean age, $59.6{\pm}9.3years$) underwent CMR-CENTRA in preparation for EAM. The CMR-CENTRA data were acquired at five different scan times: 0 seconds, 5 seconds, 10 seconds, 15 seconds, and 20 seconds after an intravenous injection of contrast media. To evaluate the degree of contrast enhancement, right atrial relative contrast (RA-RC) and left atrial relative contrast (LA-RC) on the CMR-CENTRA scans were assessed at each time point. The three-dimensional (3D) reconstruction of the RA and LA for the EAM system was performed using the CMR-CENTRA data. Results: A CMR-CENTRA at a scan time of 10 seconds showed significantly greater LA-RC (P < 0.05) compared with all other scan times. A CMR-CENTRA at a scan time of 15 seconds showed significantly greater RA-RC (P < 0.05) compared with all other scan times. In the 3D reconstruction of the RA, the success rates of CMR-CENTRA at scan times of 10 seconds and 15 seconds were 18% and 100%, respectively. In the 3D reconstruction of the LA, the success rates of CMR-CENTRA at 10- and 15-second scan times were 100%. Conclusion: The CMR-CENTRA data acquired at 15 seconds after the injection of contrast media is appropriate for the preparation of an EAM system that is focused on the RA and LA in patients with AF.

Effects of activation of protein kinase C on the regulation of atrial natriuretic peptide(ANP) by isolated perfused left atria (백서의 심방관류모델에서 protein kinase C의 활성화가 atrial natriuretic peptide(ANP) 조절에 미치는 영향)

  • Kang, Chang-won;Kang, Hyung-sub;Lee, Ho-il
    • Korean Journal of Veterinary Research
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    • v.37 no.4
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    • pp.735-744
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    • 1997
  • 심방근 세포는 심방이뇨호르몬을 합성, 저장 그리고 분비하며, 세포내외 이온의 농도, 수분균형 및 혈압 등을 조절하는 것으로 알려져 있다. 또한 심방근의 인장자극에는 Atrial Natriuretic Peptide(ANP)를 2단계(분비, 유리)의 과정으로 이루어져 있으며, 이에 따른 심방이뇨호르몬의 분비 조절기전에 대하여서는 명확히 알려져 있지 않다. 따라서 본 연구는 백서의 심방근 적출관류 모델을 이용하여 protein kinase C와 ANP 조절의 상관관계를 밝히고 분비와 유리의 과정중 어떠한 과정을 이용하여 분비자극에 영향을 주는지를 관찰하기 위하여 본 실험을 실시하였다. PKC 활성제인 PMA(phorbol 12-mystrate 13-acetate)는 ANP의 유리를 현저하게 증가시켰으며, PKC 억제제인 H-7(1-(5-isoquinoline sulfonyl)-2-methyl piperazine dihydrochlo-ride)에 의해 유리를 억제시켰다. PMA와 H-7을 동시에 처리한 경우 PMA에 의하여 증가된 ANP의 유리가 H-7에 의하여 차단됨을 관찰할 수 있었다. 따라서 백서의 관류 심방에서의 ANP 분비 증가는 PKC 활성화에 의하여 이루어지며, ANP분비의 2단계중 ANP 유리에 영향을 줌을 알 수 있었다.

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