• Title/Summary/Keyword: Pulmonary Hypertension

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Heartworm Extraction in a Pitbull Terrier Dog with Heavy Worm Burden Using A Loop Snare (심한 심장사상충 감염증에 걸린 핏불테리어 개에서 Loop Snare를 이용한 심장사상충 제거술)

  • Kim, Ji-Yoon;Yoon, Won-Kyoung;Yang, Hye-Mi;Choi, Won-Jin;Kim, Hyun-Wook;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.412-416
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    • 2014
  • A 7-year-old intact male Pitbull terrier dog was presented with complaints of marked abdominal distension and severe exercise intolerance. Diagnostic studies found a right-sided cardiomegaly with marked dilation of pulmonary arteries, diffuse interstitial pulmonary infiltration and heavy worm burden in the right atrium and ventricle. Color and spectral Doppler echocardiography also revealed tricuspid and pulmonic regurgitation indicating severe pulmonary hypertension. The 104 heartworms were removed by interventional extraction using a loop snare (Snare, Boston Scientific, USA) through external jugular vein. After heartworm removals, the clinical condition of this dog was remarkably improved. To author's best knowledge, this is the first case of interventional heartworm extraction using a loop snare in Korea.

Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

  • Jang, Woo Sung;Cho, Joon Yong;Lee, Jong Uk;Lee, Youngok
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.344-349
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    • 2016
  • Background: Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. Methods: Between March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups. Results: At the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were $2.1{\pm}1.0m/sec$ and $0.9{\pm}0.9m/sec$, respectively (p=0.001). Although the incidence of grade 3-4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: $6.5{\pm}3.4years$; group II: $3.8{\pm}2.2years$; p=0.037). Conclusion: Monocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3-4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction.

Clinical courses and diagnoses of neonates who are transferred due to mild respiratory distress soon after birth in a university hospital (일개 대학병원에서 출생 초기 경미한 호흡곤란을 주소로 전원된 신생아의 임상경과 및 진단)

  • Seo, Jee Hyue;Lee, Kyo Ho;Lee, Eun Sil
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.89-93
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    • 2014
  • Background: This study was conducted to investigate the epidemiological features, clinical courses, and diagnoses of neonates who are transferred to neonatal intensive care unit of Yeungnam University Hospital due to tachypnea soon after birth. Methods: Based on medical records, we performed a retrospective study of neonatal intensive care unit admissions due to tachypnea from January 2010 to December 2013. Results: A total of 311 neonates were included in this study. The patient characteristics showed male predominance at 2.65:1. Among the 311 neonates with tachypnea, 127 (40.8%) neonates needed oxygen supply, and 54 (17.4%) neonates needed assisted mechanical ventilation. Transient tachypnea of the newborns (TTN) (158, 50.8%) showed the highest incidence, followed by pneumonia (63, 20.3%), extrapulmonary infection (37, 11.9%), respiratory distress syndrome (21, 6.8%), air leak (16, 5.1%), meconium aspiration syndrome (12, 3.9%), congenital heart disease (5, 1.6%), metabolic acidosis (3, 1%), primary pulmonary hypertension of newborns (2, 0.6%) and anemia (2, 0.6%). Conclusion: Although the neonates with tachypnea showed no other respiratory distress symptom, clinicians should be aware of the possibility of other pulmonary diseases as well as TTN and their extra-pulmonary causes. If tachypnea does not improve within a few hours, the clinician should consider further evaluation and management as soon as possible.

Effect of Aprotinin on Changes in Plasma Thromboxane $B_2$ and Endothelin-1 Concentratin after Extracorporeal Circulation (체외순환후 혈중 Thromboxane $B_2$와 Endothelin-1 농도 변화에 미치는 Aprotinin의 효과)

  • Lim, Cheong;Yun, Tae-jin;Kim, Yeon-seung;Kim, Seung-hoo;Lee, Jae-dam;Rho, Joon-Ryang;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.33 no.3
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    • pp.221-229
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    • 2000
  • Background: Thromboxane A2 and endothelin-1 are the potent vasoconstrictors affecting pulmonary pathophysiology in response to whole body inflammatin following CPB. Aprotinin, as an antiiflammatory agent, may decrease the release of such vasoactive substance from pulmonary tissues, preventing pulmonary hypertension after cardiopulmonary bypass. Material and Method: Ten mongrel dogs(Bwt. ac. 20kg) were subjected to cardioupulmonary bypass for 2 hours and postbypass pulmonary vascular resistance(0, 1, 2, 3 hours) were compared with prebypass level. The dogs were divided into 2 groups; control group(n-5) and aprotinin group(n=5). In the aprotinin group, aprotinin was administered as follows; 50,000 KIU/kg mixed in pump priming solution, 50,000 KIU/kg prebypass intravenous infusion over 30 minutes, 10,000 KIU/kg/hour postbypass continuous infusion. Prebypass and postbypass 0, 1, 2, 3 hour pulmonary vascular resistance were measured. At prebypass and postbypass 0, 90, 180 minutes, blood samples were obtained from pulmonary arterial and left atrial catherers for the assay of plasma thromboxane B2 a stable metabolite of thromboxane A2, and endothelin-1 concentrations. Result: The ratios of pustbypass over prebypass pulmonary vascular at postbypass 0, 1, 2, 3 hours were 1.28$\pm$0.20, 1.82$\pm$0.23, 1.90$\pm$0.19, 2.14$\pm$0.18 in control group, 1.58$\pm$0.18, 1.73$\pm$0.01, 1.66$\pm$0.10, 1.50$\pm$0.08 in aprotinin group ; the ratios gradually increased in control group while decreased or fluctuated after postbypass 1 hour in aprotinin group. There was statistically significant difference between control group and aprotinin group at postbypass 3 hours(P=0.014). Pulmonary arterial plasma concentration of thromboxane B2(pg/ml) at prebypass, postbypass 0, 90, 180 minutes were 346.4$\pm$61.9, 529.3$\pm$197.6, 578.3$\pm$255.8, 493.3$\pm$171.3 in control group, 323.8$\pm$118.0, 422.6$\pm$75.6, 412.3$\pm$59.9, 394.5$\pm$154.0 in aprotinin group. Left atrial concentrations were 339.3$\pm$89.2, 667.0$\pm$65.7, 731.2$\pm$192.7, 607.5$\pm$165.9 in control group, 330.0$\pm$111.2, 468.4$\pm$190.3, 425.4$\pm$193.6, 4.7.3$\pm$142.8 in aprotinin group. These results showed decrement of pulmonary thromboxane A2 generation in aprotinin group. Pulmonary arterial concentrations of endothelin-1(fmol/ml) at the same time sequence were 7.84$\pm$0.31, 13.2$\pm$0.51, 15.0$\pm$1.22, 16.3$\pm$1.73 in control group, 7.76$\pm$0.12, 15.3$\pm$0.71, 22.6$\pm$6.62, 14.9$\pm$1.11 in aprotinin group. Left atrial concentrations were 7.61$\pm$17.2, 57.1$\pm$28.4, 18.9$\pm$18.2, 31.5$\pm$20.5 in control group, 5.61$\pm$7.61, 37.0$\pm$26.2, 28.6$\pm$21.7, 37.8$\pm$30.6 in aprotinin group. These results showed that aprotinin had no effect on plasma endothelin-1 concentration after cardiopulmonary bypass. Conclusion: Administration of aprotinin during cardiopulmonary bypass could attenuate the increase in pulmonary vascular resistance after bypass. Inhibition of pulmonary thromboxane A2 generation was thought to be one of the mechanism of this effect. Aprotinin had no effect on postbypass endothelin-1 concentration.

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The Prevalence of Chronic Degenerative Disease and Utilization of Medical Facility in Rural Population (농촌지역(農村地域) 주민(住民)의 만성퇴행성질환(慢性退行性疾患) 유병률(有病率) 및 이용의료기관(利用醫療機關))

  • Ann, Kil-Soo;Chun, Byung-Yeol;Yeh, Min-Hae
    • Journal of agricultural medicine and community health
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    • v.21 no.2
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    • pp.209-220
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    • 1996
  • This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

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BMPs and their clinical potentials

  • Kim, Mee-Jung;Choe, Senyon
    • BMB Reports
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    • v.44 no.10
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    • pp.619-634
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    • 2011
  • Bone morphogenetic protein (BMP) signaling in diseases is the subject of an overwhelming array of studies. BMPs are excellent targets for treatment of various clinical disorders. Several BMPs have already been shown to be clinically beneficial in the treatment of a variety of conditions, including BMP-2 and BMP-7 that have been approved for clinical application in nonunion bone fractures and spinal fusions. With the use of BMPs increasingly accepted in spinal fusion surgeries, other therapeutic approaches targeting BMP signaling are emerging beyond applications to skeletal disorders. These approaches can further utilize next-generation therapeutic tools such as engineered BMPs and ex vivo-conditioned cell therapies. In this review, we focused to provide insights into such clinical potentials of BMPs in metabolic and vascular diseases, and in cancer.

Hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction in a Maltese dog

  • Yoon, Won-Kyoung;Suh, Sang-Il;Oh, Yeon-Su;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.55 no.3
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    • pp.209-211
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    • 2015
  • An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.

Repair of intracardiac defect under simple deep hypothermia in infancy without cardiopulmonary bypass: report of 3 cases (단순 초저온법에 의한 개심술: 3례 보)

  • 조범구
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.189-196
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    • 1984
  • Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

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Total Left Lung Atelectasis Secondary to Patent Ductus Arteriosus (동맥관개존증에 합병한 좌전무기폐의 치험례)

  • 오재상
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.316-320
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    • 1978
  • This report presents a case of patent ductus arteriosus complicated with total left lung atelectasis and mitral regurgitation. Her mother complained growth retardation and exertional dyspnea. The 3 year old girl had large patent ductus arteriosus [Qp/Qs=5.6] which resulted in moderate pulmonary hypertension, left atrial hypertrophy and enlargement, consequently the left main bronchus was compressed between the dilated left atrium and aorta. We would like conclude the cause of mitral regurgitation as the result of annular dilatation secondary to left atrial enlargement rather than congenital associated to patent ductus arteriosus. 3 weeks later from ligation of patent ductus arteriosus, the left atrial dimension was markedly reduced echocardiographically [from 3.9cm to 2.7cm], and the left lung progressively aerated by halves.

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Congeniral Coronary Arteriovenous Fistula; Right Coronary- Right Ventricle; Report of Two Cases (우관상동맥에서 우심실로 개구되는 선천성 관동맥루;수술치험 2례)

  • 윤영철
    • Journal of Chest Surgery
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    • v.26 no.8
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    • pp.638-642
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    • 1993
  • Congenital coronary arteriovenous fistula is relatively uncommon and widespread use of echocardiogram and selective coronary angiogram are being recognized with increasing frequency. The right coronary artery is most commonly involved and the fistulous communication is most common to right ventricle. Surgical correction is strongly recommended to prevent the development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and pulmonary hypertension, as well as coronary aneurysm formation, with subsequent rupture or embolism. We report two cases of coronary arteriovenous fistula originated from right coronary artery terminated in the right ventricle. These 8 year-old female and 7 year-old male patients had surgical interventions using cardiopulmonary bypasses.

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