• Journal of Chest Surgery
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• 제22권6호
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• pp.894-900
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• 1989

It has been suggested that mixed venous $O_{2}$ tension is a predicor of cardiac output especially in a critically ill patient after an open heart surgery. From April 1988 through September 1989, we monitored mixed venous $O_{2}$ tension and pulmonary arterial pressure in 48 patients with acyanotic congenital heart disease at postoperative 1 hour, 6 hour, 12 hour, 24 hour, and 48 hour respectively. They were divided into Group I, with severe pulmoary hypertension, and Group II, without severe pulmonary hypertension. In Group I, mixed venous $O_{2}$ tension and cardiac index showed significant increase with time (p<0.05), but the ratio of pulmonary-aortic systolic pressure didn't show significant change. The increase was significant only 24 hour after operation, and so this low cardiac performance in early postoperative period should be considered when postoperative management is being planned in the risky patient. In Group II, all of the three variables didn't show any significant change with time. The correlation coefficient between mixed venous $O_{2}$ tension and cardiac index was significantly different from zero in both Group I (p<0.001) and group II (p<0.05) at each imeperiod, but the ratio of pulmonary-aortic systolic pressure didn't correlated well with the other 2 variables. Our study showed that serial determination of mixed venous $O_{2}$ tension in acyanotic congenital heart disease could be used as a guide in estimating the cardiac index postoperatively.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.124-131
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• 2014

Background: Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance. Methods: A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups. Results: Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group. Conclusion: Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.

• Korean Journal of Radiology
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• 제20권6호
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• pp.976-984
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• 2019

Objective: To establish diagnostic criteria for pulmonary arterial hypertension (PAH) in children by using parameters obtained through noninvasive cardiac computed tomography (CCT). Materials and Methods: We retrospectively measured parameters from CCT images of children from a single institution in a multiple stepwise process. A total of 208 children with mean age of 10.5 years (range: 4 days-18.9 years) were assessed. The variables were classified into three groups: the great arteries; the ventricular walls; and the bilateral ventricular cavities. The relationship between the parameters obtained from the CCT images and mean pulmonary arterial pressure (mPAP) was tested and adjusted by the children's body size. Reference curves for the pulmonary trunk diameter (PTD) and ratio of diameter of pulmonary trunk to ascending aorta (rPTAo) of children with CCT images of normal hearts, adjusted for height, were plotted. Threshold lines were established on the reference curves. Results: PTD and rPTAo on the CCT images were significantly positively correlated with mPAP (r > 0.85, p < 0.01). Height was the body size parameter most correlated with PTD (r = 0.91, p < 0.01) and rPTAo (r = -0.69, p < 0.01). On the basis of the threshold lines on the reference curves, PTD and rPTAo both showed 88.9% sensitivity for PAH diagnosis, with negative predictive values of 93.3% and 92.9%, respectively. Conclusion: PTD and rPTAo measured from CCT images were significantly correlated with mPAP in children. Reference curves and the formula of PTD and rPTAo adjusted for height could be practical for diagnosing PAH in children.

• Journal of Chest Surgery
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• 제17권1호
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• pp.48-52
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• 1984

Total anomalous pulmonary venous connection [TAPVC] defines a group of congenital heart disease which have in common the entire pulmonary venous drainage returning directly or indirectly to the right atrium instead of to the left atrium. Although this disorder represents only 1.3% of cases of congenital heart disease, if untreated the resultant mortality is greater than 80% in the 1st year of life. And since there is no satisfactory palliative treatment, correction of TAPVC Is high on the list of indications for open heart surgery in the 1st year of life. This paper describes 10 patients who underwent surgical correction of this disorder at SNUH between 1978 and 1983. 1. 7 were males and 3 females, with ages ranging from 5 months to 24 years. 2. 7 were supracardiac type, 2 cardiac type, and 1 mixed type TAPVC. We didnt experience infracardiac type. 3. All showed some degree of pulmonary hypertension preoperatively. 4. In 4 cases of supracardiac type, total circulatory arrest was used in brief period during anastomosis between common pulmonary venous trunk and left atrium. In the other cases, usual cardiopulmonary bypass with moderate to deep hyperthermia was used. 5. There were 2 cases of mortality; 1 died at operation, and the other at 4 months due to congestive heart failure. 6. Mortality seemed not closely related to age, body weight, or severity of pulmonary hypertension.

• Applied Microscopy
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• 제21권1호
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• pp.86-107
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• 1991

An experimental study was performed to observe the early effects of monocrotaline on pulmonary vascular system by means of light microscopy and scanning electron microscopy, attempting to expore the mechanism behind the process of pulmonary hypertension. Experimental animal(Sprague-Dawley male rats ; 150-200g B. W.) were intra-peritoneal administered with 100mg/kg B. W. monocrotaline. Authors observed light microscopically various gradational increase of wall thickness in pulmonary muscular and non-muscular arteries in duration from 2 weeks to 5 weeks after monocrotaline administration and the changes were more sever in the latter than the former. The scanning electron microscopy shows severe and diffuse endothelical cell swelling, microvilli and microbleb formation since 1 hour after monocrotaline administration and during the course, after 5 hours the severity of endothelial cell damage was prominent with presence of fibrin, webs, platelet thrombi and white cell adherence. It was concluded that the monocrotaline primarily induced severe and diffuse endothelial cell damage of pulmonary arteries and laterly added the participation of platelets, which attributed to the pathogenesis of monocrotaline induced pulmonary vascular lesions in relation to pulmonary hypertension.

• Journal of Yeungnam Medical Science
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• 제31권1호
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• pp.38-42
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• 2014

Cardiovascular beriberi is caused by thiamine deficiency and usually presents as high cardiac output failure associated with predominantly right-sided heart failure and rapid recovery after treatment with thiamine. Because of its rarity in developed countries, the diagnosis can often be delayed and missed. We recently experienced a case of cardiovascular beriberi with pulmonary hypertension which successfully treated with thiamine infusion. A 50-year-old man with chronic heavy alcoholics was refered to our department for dyspnea with mental change. Echocardiography showed marked right ventricular (RV) dilatation and flattening of the interventricular septum with a D-shaped deformation of the left ventricle. Moderate tricuspid valve regurgitation was found and estimated RV systolic pressure was 52 mm Hg. Because of his confused mentality and history of chronic alcohol intake, neurological disorder due to thiamine deficiency was suspected and intravenous thiamine was administered and he continuously received a daily dose of 100 mg of thiamine. Follow up echocardiography showed marked reduction of RV dilatation and improvement of a D-shaped deformation of the left ventricle. He finally diagnosed as cardiovascular beriberi on the basis of dramatic response to intravenous thiamine. Thiamine deficiency can cause reversible pulmonary hypertension, and can still be encountered in the clinical setting. Thus high index of suspicion is critically needed for diagnosis.

• Journal of Preventive Medicine and Public Health
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• 제42권1호
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• pp.21-28
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• 2009

Objectives : Whilst hypertension exerts a negative effect on several organs there have been few studies regarding its effect on pulmonary function. The objective of this study was to examine the relationship between hypertension and pulmonary function in rural Korean adults Methods : In 2006, 2534 people were recruited, aged 40 to 70, in Kangwha County. We selected 1454(male: 624, female: 830) participants whose pulmonary function results were repeatable. Blood pressure(BP) was measured twice and the average calculated. Participants were divided into two groups(hypertensive group and non-hypertensive group) in accordance with The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Pulmonary function was measured by dry rolling seal spirometry. Forced expiratory volume in the one second and forced vital capacity were converted into percent-predicted values based on average pulmonary function amongst Koreans. Results : The number of hypertensive participants in the present study was 460(male: 205, female: 255) and the number of non-hypertensive participants was 994(male: 419, female: 575). Our findings have shown that the mean values for expiratory volume in the one second and forced vital capacity were significantly lower for hypertensive people than for non-hypertensive people, among women(P=0.002 for forced expiratory volume in the one second, p<0.001 for forced vital capacity volume). Odds ratio analysis revealed that hypertensive participants were more likely to have lower pulmonary function than non-hypertensive participants, again significantly among women. Conclusions : The pulmonary function of hypertensive women was significantly lower than that of non-hypertensive women aged 40-70.

• Neonatal Medicine
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• 제18권1호
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• pp.96-103
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• 2011

목적: 극소 저체중 출생아에서 폐고혈압증은 기관지 폐 이형성증의 대표적인 심폐관련 합병증으로 높은 사망률과 합병증과 연관되어 있으나, 이에 대한 연구는 드문 실정이다. 이에 본 저자들은 기관지 폐 이형성증을 가진 극소 저체중 출생아에서 폐고혈압증의 유병률, 경과 및 치료뿐 아니라 예후 및 이와 관련된 인자들에 대해 확인해 보고자 하였다. 방법: 2000년 1월부터 2007년 7월까지 성균관대학교 의과대학 삼성서울병원 신생아 집중치료실에 입원한 출생 체중 1,500g 미만 환아 865명 중 28일 이상 산소 치료를 필요로 하였던220명을 대상으로 하였다. 심장 초음파 검사상 삼첨판 역류 속도 3 m/s 이상이 확인되면서, 우심실 비대 혹은 심실 중격이 평형함이 관찰되는 경우를 폐고혈압으로 진단하였으며, 이들을 대조군과 비교하였다. 환아들의 의무기록을 후향적으로 분석하여, 인구학적, 주산기 인자, 합병증, 사망률을 비교하였으며, 폐고혈압증을 가진 환아 중 사망군과 생존군으로 나누어 이들의 특성 및 관련인자를 분석하였다. 결과: 기관지 폐 이형성증을 가진 VLBWI 218명 중 14명(6%)에서 폐고혈압증이 발생하였으며, 모두 중등도 이상의 기관지 폐 이형성증에서 발생하였다. 폐고혈압증은 평균 생후 133일(40-224일)에 진단 받았으며, 중증 기관지 폐 이형성증, 부당 경량아, 외부 환아는 폐고혈압증 발생과 관련된 인자이다. 기관지 폐 이형성증에서 발생한 폐고혈압증의 사망률은 57%이며, 중증 기관지 폐 이형성증은 사망의 중요한 원인이다. 생존한 환아에서 회복되는데 까지 걸리는 시간은 평균 3개월이었다 결론: 극소 저체중 출생아에서 기관지 폐 이형성증과 관련된 폐고혈압증은 높은 사망률 및 합병증을 보이며, 이들의 발생 및 예후는 기관지 폐 이형성증 정도와 연관성이 있다. 이들의 조기진단을 위해 중등도 이상의 기관지 폐 이형성증 환아에서 정기적인 선별검사 및 퇴원 이후에도 장기간 지속적인 추적 관찰이 필요하다.

• Tuberculosis and Respiratory Diseases
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• 제56권1호
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• pp.67-76
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• 2004

연구배경 : 만성호흡기질환 환자에서 폐동맥고혈압은 불량한 예후를 나타낸다. 접근성이 용이하고 비침습적인 방법으로서 혈청 NT-proBNP농도 측정이 폐동맥고혈압 진단에 유용성이 있는지 알아보기 위하여 본 연구를 진행하였다. 방 법 : 임상적으로 수축기 폐동맥고혈압이 의심되는 환자 29명을 대상으로 전기화학발광 면역분석법을 이용하여 혈청 NT-proBNP농도를 측정하였고, 동맥혈가스검사, 혈청 생화학검사, 폐기능검사, 그리고 도플러 심초음파검사를 실시하여 우심실 수축기압을 통해 수축기 폐동맥압을 예측하였다. 결 과 : 로그 값으로 치환한 혈청 NT-proBNP농도와 수축기 폐동맥압과는 양성 선형 상관관계를 갖고 있었다(Correlation coefficiency: 0.783, p-value < 0.001). 혈청 NT-proBNP 농도는 우심실 수축기압, 우심실 비대, 심실간 중격의 편평화, 우심실 확장과 유의한 관련이 있었다. 결 론 : 임상적으로 폐동맥고혈압을 의심하는 환자에서 혈청 NT-proBNP 농도 측정은 간단하게 폐동맥고혈압 유무를 알 수 있는 유용한 표지자로서 사용이 가능할 것으로 보이며, 이에 대한 추가 연구가 필요하리라 생각된다.

• 대한본초학회지
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• 제26권1호
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• pp.59-63
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• 2011

Objectives : Elastic fibers are found in the skin, lungs, arteries, veins and other structures. The defects of elastic matrix aggravate hypertension which is associated with alteration in the great arteries, arteries, and arterioles. The elastase inhibitors were undergoing in clinical studies about emphysema and pulmonary hypertension. This study was designed to investigate the effect of Astragali Radix extracts (AR) on elastase activity and anti-oxidative effects. Methods : The elastase inhibitory activity and DPPH (1,1-diphenyl-2-picrylhydrazyl) and NO free radical scavenging activities of AR were measured. Results : The elastase activity was significantly inhibited by AR. The significant DPPH and NO free radical scavenging activities were observed in AR as well. Conclusion : AR showed the anti-elastase effects and anti-oxidative activities in vitro. These results suggest that AR may be a possible drug for the treatment of pulmonary emphysema and pulmonary hypertension.