• Journal of Chest Surgery
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• v.22 no.6
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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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• v.77 no.3
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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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• v.20 no.6
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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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• v.17 no.1
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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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• v.21 no.1
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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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• v.31 no.1
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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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• v.42 no.1
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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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• v.18 no.1
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• pp.96-103
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• 2011

Purpose: Although infants with bronchopulmonary dysplasia (BPD) are at risk of developing secondary pulmonary hypertension (PH), which is associated with significant morbidity and mortality, little has been reported about the incidence, clinical course and prognosis of PH secondary to BPD in premature infants. This study was done to investigate the incidence, risk factors, clinical course, and the ultimate prognosis of PH developed secondary to BPD in very low birth weight infants (<1,500 g). Methods: Medical records of very low birth weight infant (VLBWI) admitted to Samsung Medical Center NICU from January 2000 to July 2007 were reviewed retrospectively. BPD was defined by Jobe's classification. The diagnosis of pulmonary hypertension was established as velocity of tricuspid valve regurgitation (TR) ${\geq}$3 m/s and a flattening of the intraventricular septum by conducting Doppler echocardiography. Results: The incidence of pulmonary hypertension was 6% in VLBWI with BPD and it developed in moderate to severe BPD. The diagnosis of pulmonary hypertension was made on postnatal 133 days (range 40-224 days) and the risk factors related to developing pulmonary hypertension were severe BPD, small for gestational age and outborn infants. The mortality rate was 57% and especially higher in severe BPD (70%). The time to recovery spent 3 months (range 1-10 months) in survived patients. Conclusion: Based on the results of this research, pulmonary hypertension secondary to BPD in VLBWI related to severity of BPD and had a poor prognosis. We expect that regular long-term echocardiography may be helpful in treating reversible in VLBWI with moderate to severe BPD.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.67-76
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• 2004

Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Method : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.

• The Korea Journal of Herbology
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• v.26 no.1
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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.