• 제목/요약/키워드: Pulmonary Hypertension

검색결과 383건 처리시간 0.025초

타카야수동맥염에 의한 만성 폐고혈압에서 Nitric Oxide가스와 Molsidomine의 치험 3예 (Role of Nitric Oxide and Molsidomine in the Management of Pulmonary Hypertension in Takayasu's Arteritis)

  • 진재용;이성순;이상수;심태선;임채만;고윤석;김우성;김동순;김원동;이상도
    • Tuberculosis and Respiratory Diseases
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    • 제48권6호
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    • pp.964-972
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    • 2000
  • 저자들은 타카야수동맥염에 의한 만성 폐고혈압 환자 3예를 대상으로 혈관확장제 (NO 및 molsidomine)가 이들의 폐고혈압을 완화시킬 수도 있음을 관찰하였으며, 이와 관련하여 보다 많은 연구가 이루어져야 하리라 생각된다.

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Occult Gastric Cancer Presenting as Hypoxia from Pulmonary Tumor Thrombotic Microangiopathy

  • Mandaliya, Rohan;Farhat, Salman;Uprety, Dipesh;Balla, Mamtha;Gandhi, Apurva;Goldhahn, Richard;Auerbach, Herbert;Christensen, Chris;Reed, Conrad;Cohen, Sidney
    • Journal of Gastric Cancer
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    • 제14권2호
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    • pp.142-146
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    • 2014
  • Pulmonary tumor thrombotic microangiopathy (PTTM) causing fatal pulmonary hypertension is a rare presentation of malignancy. In general, patients with PTTM rapidly succumb to death due to severe hypoxia. To date, very few cases of PTTM have been reported in the literature; and most of these cases were from gastric cancer and were diagnosed on post mortem autopsy, as it is extremely challenging to make an ante mortem diagnosis. We here report on a case of undiagnosed diffuse gastric cancer, presenting as worsening hypoxia. The clinical, radiographic, and echocardiographic features, and laboratory and pathological results were consistent with PTTM from gastric cancer. The patient was started on anticoagulation therapy, corticosteroids, and high-flow oxygen. However, her hypoxia worsened to the extent that she required ventilator support, and she died soon after intubation due to cardiac arrest. Since diffuse gastric cancer is associated with hereditary diffuse gastric cancer syndrome, cadherin 1 gene mutation analysis was performed to estimate the risk to her daughters. The test came back negative.

항인지질 증후군과 전신성 홍반성 루푸스 환자에게 발생된 만성 폐혈전색전성 폐동맥 고혈압에 대해 시행한 혈전내막제거술 (Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension in a Patient with Antiphospholipid Syndrome and Systemic Lupus Erythematosus)

  • 강필제;김정원;이재원
    • Journal of Chest Surgery
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    • 제40권12호
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    • pp.867-870
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    • 2007
  • 항인지질 증후군(antiphospholipid syndrome)은 정맥, 동맥의 혈전증, 혈소판 감소증, 반복적인 유산 등과 함께 lupus anticoagulant (LAC)와 anticardiolipin antibody (aCL)가 반복적으로 양성 반응을 보이는 질환을 말하며 호흡기 증후 발현은 상대적으로 드물다. 저자들은 항인지질 증후군 및 전신성 홍반성 루푸스 환자에서 발생한 만성적인 폐혈전색전증에 대하여 폐동맥 내막절제술, 특히 원위부에 있는 폐혈전색전증을 왼쪽 폐의 대열을 분리한 뒤 좌하엽 구역 동맥을 절제하여 혈전색전 제거술을 성공적으로 시행하였기에 문헌고찰과 함께 국내 최초로 보고하는 바이다.

동맥관 개존증의 임상적 고찰 (A retrospective clinical study of isolated patent ductus arteriosus)

  • 곽영태
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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만성 폐전색증의 전색 제거술 치험 -1례 보고- (Pulmonary Thromboembolectomy of Chronic Pulmonary Thromboembolism)

  • 문석환
    • Journal of Chest Surgery
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    • 제21권5호
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    • pp.911-917
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    • 1988
  • Pulmonary thromboembolism originated most commonly from the venous thrombus, especially deep vein thrombus in the leg, which migrated to and occluded the pulmonary vasculatures. The failure of clot lysis and repeated embolic episodes resulted in the hemodynamic compromise -that is- in the increasing in the pulmonary vascular resistance, which would cause the right ventricle failure[Car Pulmonale]. Under the cardiopulmonary bypass, 20 year old male patient was treated successfully by thromboembolectomy of pulmonary thromboembolism with pulmonary hypertension, which originated from the deep vein thrombus in the leg. The results of radiologic studies and clinical evaluations were excellent in that the postoperative lung perfusion scan showed the newly increased perfusion of post-embolectomy territories and in the arterial blood gas finding of 76 from 66[mmHg] in PaO2. The patient was uneventful and discharged on postop. $ 14 days with anticoagulant continued.

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원발성 담관성 간경변과 동반된 문맥폐고혈압 1예 (A Case of Portopulmonary Hypertension Associated with Primary Biliary Cirrhosis)

  • 김세중;이은주;정기환;강은해;이승룡;임홍의;임형준;이상엽;김제형;신철;심재정;인광호;강경호;유세화
    • Tuberculosis and Respiratory Diseases
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    • 제62권5호
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    • pp.421-426
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    • 2007
  • 진행성 간질환의 합병증으로 발생하는 문맥폐고혈압은, 이차성 폐동맥고혈압 중에서 진행성 간질환에 의한 문맥고혈압과 연관된 폐동맥고혈압으로 분류되며, 독특한 임상적, 병태생리학적 특징을 보인다. 임상양상은 점진적인 운동성 호흡곤란, 흉통 등을 호소하지만, 증상 없이 우연히 발견되는 경우도 있다. 심초음파 검사를 통해 예비적으로, 우심장 도관삽입으로 직접 우심실 및 평균 폐동맥압을 측정하여 진단할 수 있다. 치료는 칼슘통로차단제, 프로스타노이드 등을 사용하지만, 근본적인 치료를 위해서는 간 및 폐이식을 고려해야 한다. 저자들은 53세 여자로 20년 전에 간경변을 진단받은 후 호흡곤란으로 내원한 환자에게서, 간경변의 원인으로 원발성 담관성 간경변을 진단하고, 호흡곤란의 원인으로 문맥폐고혈압을 진단하여 치료하였기에 문헌고찰과 함께 보고한다.

Association of PPARGC1A Gene Variants with Hypertension in Korean Population

  • Jin, Hyun-Seok;Park, Sangwook
    • 대한의생명과학회지
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    • 제27권1호
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    • pp.12-18
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    • 2021
  • Hypertension (HTN) is one of the cardiovascular disease risk factors. Peroxisome proliferator-activated receptor γ coactivator 1 alpha (PPARGC1A) is involved in a master modulator of mitochondrial biogenesis, and pulmonary arterial hypertension. In this study, we report results of PPARGC1A were associated with hypertension and its intermediate phenotype of systolic (SBP) and diastolic blood pressure (DBP) in the Korean population. In detail, identifying a susceptibility locus, 3 SNPs for HTN, 2 SNPs for SBP, 3 SNPs for DBP at P<0.05. Among them, rs1472095 in PPARGC1A gene statistically demonstrated one of the significant correlations with Hypertension (P-value=0.00359, OR=0.8, 95% CI=0.68~0.93). The minor allele (T) of PPARGC1A was statistically associated with the increased value of DBP, SBP, and the increase risk of hypertension. We aim to manifest a significant association between genetic variant in PPARGC1A and hypertension. This finding suggested that association of PPARGC1A genetic polymorphism and HTN accelerates our understanding of blood pressure control and underlines potential drug targets for treatment of hypertension.

소아 선천성 개심수술후의 폐동맥 고혈압 발작증 (Pulmonary Hypertensive Crises After Surgery for Congenital Heart Defects in Children)

  • 서필원
    • Journal of Chest Surgery
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    • 제22권6호
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    • pp.944-950
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    • 1989
  • Children with congenital cardiac defects associated with high pulmonary artery pressure may die despite accurate surgery. Postoperative mortality and morbidity have been attributed to acute rises in pulmonary artery pressure and resistance. Acute pulmonary hypertensive crisis is defined as a paroxysmal event in which pulmonary arterial systolic pressure rises to or above systemic levels followed by a rapid fall in systemic pressure and a minor pulmonary hypertensive event is defined as an acute rise in pulmonary arterial pressure to more than 80 % of systemic levels but without a fall in systemic pressure. From Oct. 1988 to Jul. 1989, we experienced 23 patients who showed many pulmonary hypertensive crises after operation in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital. Their preoperative PAP/SAPs were 53 to 123 %[mean 93.3%] and diagnoses were VSD[7], TAPVR[5], TGA[4], AVSD[3], MS[1], DORV[1], Truncus arteriosus[1], and AP window[l]. There were 9 deaths among 23 patients and they showed many pulmonary hypertensive crisis episodes during postoperative intensive care, which was managed by sedation, hyperventilation, oxygen, and acidosis correction and which decreased after using tolazoline. In view of our experience, we recommend that pulmonary artery pressure should be monitored in congenital heart defected patient with preoperative pulmonary hypertension to confirm and to manage the pulmonary hypertensive crisis accurately and using tolazoline is helpful in the treatment of pulmonary hypertensive crisis.

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