• Title/Summary/Keyword: Rheumatic heart disease

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The Clinical Results of Open Heart Surgery with Coronary Artery Bypass Grafting (관상동맥 우회로 조성수술을 병행한 개심수술의 임상성적)

  • 유경종;강면식
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.171-176
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    • 1996
  • From March, 1983 to June, 1994, twenty-two patients underwent coronary artery and combined operations. The ages of the patients ranged from 42 years to 72 years (mean 60.4$\pm$8.2 years). There were 17 male and 5 female patients. The left ventricular (LV) ejection fraction ranged from 25% to 65% (mean 46.9$\pm$14.2%). Nine patients had mechanical complication of myocardial infarction (MI), of which 5 were LV aneurysm, 3 ventricular septal defect and 1 mitral regurgitation. Nine patients had rheumatic valvular heart disease of whom 7 with aortic valve disease and 2 with mitral valve disease. Two other patients had left atrial thrombi, only one with atrial septal defect a d another with aneurysm of ascending aorta. An average of 2.1$\pm$1.0 bypasses was done, ranging from one to four. There were 3 postoperative complications; 2 perioperative MI and 1 leg wound infection. Among complicated patients, mortality was 1 patient (4.5%) due to low cardiac output syndrome after perioperative MI. With 3 to 136 months follow-up (mean 41.1$\pm$40.2 months), late mortality was 1 patient due to cerebral vascular accident. Among long-term survivors, all patients are in New York Heart Association functional class I or II. Although the number of patients was small, our surgical results were favorable. Therefore we think that coronary revascularization combined with heart operation does not increase the operative risk when associated coronary artery disease is present, and it reduces the occurrence of late death.

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INFECTIVE ENDOCARDITIS OF DENTAL ORIGIN: A CASE REPORT (치성기원으로 인한 감염성 심내막염: 증례보고)

  • Ahn, Shin-Young;Yang, Seok-Jin;Kim, Su-Gwan;Kim, Hak-Kyun;Lee, Hyo-Bin;Park, Joong-Yeop;Choi, Dong-Kook;Kim, Young-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.3
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    • pp.237-241
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    • 2006
  • Infective endocarditis remains an important, life-threatening infection despite improvements in diagnosis and management. Despite the decrease in rheumatic heart disease and the improvements in antibiotic prophylaxis, infective endocarditis has been reported with increasing frequency in the last few decades. Presumably, this is due to the rise in the incidence of intravenous drug users, carriers of prosthetic valves and other intracardiac devices, and the longer survival of patients with congenital heart disease. Despite the great advances in medical and surgical treatment, infective endocarditis is still a life-threatening disease with an estimated mortality of 27%. Infective endocarditis represents one of the few potentially fatal infections that may occur in a dental patient. Efforts to reduce the incidence of this disease usually take the form of appropriate antibiotic coverage before dental treatment, together with the establishment and maintenance of good oral health. This study is a case report of a patient who developed infective endocarditis after multiple tooth extractions due to chronic periodontitis of dental origin.

Mitral and Aortic Valce Replacement with Patch Enlargement of Narrow Aortic Annulus (협소한 대동맥판윤의 첨포확대후 대동맥 및 승모판막 대치술 치험 1예)

  • 강면식
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.56-60
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    • 1979
  • Replacement of the aortic valve in a normal or large aortic root can be accomplished with ease and safety in most instances. The presence of a narrowed aortic annulus remains a problem in that the replaced smaller prosthetic valve has a significant resting pressure gradient across the orifice. This narrowing causes not only technical difficulties, but also increased mortality and post-op. complication. Therefore this problem deserves special attention. This report presents our experience with a case of a small aortic root caused by rheumatic heart disease [AI and MS]. This is the method of enlargement of the aortic annulus with a woven Dacron patch and replacement of a larger prosthetic aortic valve combined with mitral valve replacement.

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The pharmacological effect of the methanol extracts from Acanthopanax senticosus after immobilized and chronic swimming stresses in rats

  • Park, Hee-Dong;Kim, Yu-Ji;Yang, You-Jong;Lee, Jae-Joon;Lee, Jung-Joon;Lee, Myung-Koo
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.264.2-265
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    • 2002
  • Acanthopanax senticosus has been used clinically as tonic. anti-rheumatic and prophylactic purpose for chronic bronchitis. hypertension. ischemic heart disease. and gastric ulcer. We investigated the effects of methanol extracts from Acanthopanax senticosus (KS. KR. MS, MR, HS. HR, SS and SR) on catecholamine and cortisol content of serum after immobilization and on the exercise time to exhaustion in chronic swimming stressed rats. (omitted)

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Mitral Valve Replacement Via an Extended Transseptal Approach (광범위 경중격 좌심방절개술에 의한 승모판막치환술)

  • 정수상
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.579-582
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    • 1995
  • The extended transseptal approach to the mitral valve replacement has been used for 30 patients. There were 19 women and 11 men. Twenty five patients had rheumatic heart disease, 4 had degenerative valve ,and 1 had valve prolapse. Fifteen of 30 patients had other associated procedure; 10 had aortic valve replacement; 5 had tricuspid annuloplasty. There were no postoperative complications associated with the approaches, ie, no bleeding, no sinus node dysfuction, and no atrioventricular conduction disturbance. Despite division of the sinus node artery, preoperative atrial rhythms[3 sinus rhythms and 27 atrial fibrillations were not changed during postoperative period. The extended transseptal approach provides good mitral valve exposure without inherent complications, and is superior to that of standard approach, so we use it routinely for mitral valve procedure.

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An Analysis of Cause of Death from the Reported Death Certificates in Korea (사망신고자료(死亡申告資料)에 의한 사인분석(死因分析))

  • Lee, Dong-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.14 no.1
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    • pp.39-42
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    • 1981
  • Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart diseases and atherosclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the deads occurred or the incomplete description on the cause of death reported suggests that statistical information of cause of death from the medically certified death records is meaningful in interpreting changing patterns.

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Severe Mitral Regurgitation Due to Coronary Vasospasm, Confirmed by Ergonovine Echocardiography (에르고노빈 심초음파로 확진된 승모판 폐쇄부전을 유발한 혈관연축 1예)

  • Cha, Jung-Joon;Kyung, Chan Hee;Cho, Jang Ho;Kim, Yong Hoon;Kim, Haewon;Lee, Sung-Joo;Rim, Se-Joong;Choi, Eui-Young
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.120-123
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    • 2013
  • The common causes of organic mitral regurgitation (MR) include mitral valve prolapse (MVP) syndrome, rheumatic heart disease, and endocarditis. MR also occurs secondary to dilated cardiomyopathy and coronary artery disease. In acute severe MR, the hemodynamic overload often cannot be tolerated, and mitral valve repair or replacement must be performed immediately. We report herein a case of severe MR due to coronary vasospasm that was confirmed via ergonovine echocardiography in a 70-year-old man. He was scheduled to undergo mitral valve surgery, but it did not push through and he was put on medical therapy.

Risk factors for hypertension in elderly people aged 65 and over, and adults under age 65 (65세 이상 노인과 65세 미만 성인의 고혈압 위험요인)

  • Kim, Ka Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.162-169
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    • 2019
  • This study investigated the risk factors of hypertension among individuals under and over 65 years of age. A total of 6,152 participants were analyzed using the 6th Korean Longitudinal Study of Aging. The collected data were analyzed by Chi-square tests and logistic regression using SPSS 23. The results showed that the subjective health status, diabetes, heart disease, and degree of obesity according to BMI were risk factors affecting hypertension in individuals both under and over age 65. In adults under age 65, chronic lung disease, digestive disease, and drinking were risk factors affecting hypertension. In elderly over age 65, region, arthritis and rheumatic disease, smoking, and cognitive function were risk factors affecting hypertension. There is a need for chronic disease management in Korea due to rapid aging. In particular, it is important to analyze for effective management age-related risk factors affecting steadily increasing hypertension with age. Therefore, it is necessary to manage chronic disease management through social welfare improvement and welfare plans for the elderly, as well as personal management.

Oral Quinidine Therapy for the Maintenance of Sinus Rhythm After Mitral Valve Surgery (승모판 수술후 동율동 유지에 대한 Quinidine의 효과)

  • 윤태진
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.249-254
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    • 1993
  • Atrial fibrillation is commonly associated with organic mitral valve disease including rheumatic valvular heart diasease or mitral valve prolapse and so forth. Although spontaneous sinus reversion may occur in some patients after mitral valve operation, recurrence of atrial fibrillation is the rule in most of these patients. We have tried to maintain sinus rhythm after mital valve operation with oral quinidine therapy, and we will show the efficacy of this therapy in this report. From January 1986 to August 1992, 60 patients of mitral valvular heart disease, who had had atrial fibrillation preoperatively and gained sinus rhythm postoperatively, were selected for this study. These patients were divided into 2 groups: Control group [n=30] and Quinidine trial group [n=30]. The age,sex, duration of symptoms,left atrial size and other risk factors of the reversion to atrial fibrillation were adjusted to be similar between the two groups. The maintenance rate of sinus rhythm was calculated by Kaplan-Meier method, and the rate was significantly higher in quinidine trial group than in control group [ p=0.0001 ]. Univariate analysis was performed on the risk factors of reversion to atrial fibrillation, and the difference of maintenance rate between the two groups were corrected with this result: the difference was still statistically significant [ p=0.0205 ]. The quinidine levels were measured in postoperative days, and there were no difference of serum quinidine level between the quinidine success group and quinidine failure group. In conslusion, oral quinidine therapy was effective for the maintenance of sinus rhythm after mitral valve operation compared to control group, and there was no correlation between the serum quinidine level and clinical efficacy of quinidine therpy.

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Outcomes of Combined Mitral Valve Repair and Aortic Valve Replacement (대동맥판막 치환술과 동반시행한 승모판막 성형술 결과)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Choi, Hyun-Seok;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.463-471
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    • 2003
  • The long-term results of combined mitral valve repair and aortic valve replacement (AVR) have not been well evaluated. This study was performed to investigate the early and long-term results of mitral valve repair with AVR. Material and Method: We retrospectively reviewed 45 patients who underwent mitral valve repair and AVR between September 1990 and April 2002. The average age was 47 years: 28 were men and 17 women. Twelve patients had atrial fibrillation and three had a previous cardiac operation. The mitral valve disease consisted of pure insufficiency (MR) in 34 patients, mitral stenosis (MS) in 3, and mixed lesion in 8. Mitral valve disease was due to rheumatic origin in 24 patients, degenerative in 11, annular dilatation in 8, and ischemia or endocarditis in 2. The functional anatomy of mitral valve was annular dilatation in 31 patients, chordal elongation in 19, leaflet thickening in 19, commissural fusion in 13, chordal fusion in 10, chordal rupture in 6, and so on. Aortic prostheses used included mechanical valve in 32 patients, tissue valve in 12, and pulmonary autograft in one. The techniques of mitral valve repair included annuloplasty in 32 patients and various valvuloplasty of 54 techniques in 29 patients. Total cardiopulmonary bypass and aortic cross clamp time were 204$\pm$62 minute and 153$\pm$57 minutes, respectively. Result: Early death was in one patient due to low output syndrome (2.2%). After follow up of 57$\pm$37 months, late death was in one patient and the actuarial survival at 10 years was 96$\pm$4%. Recurrent MR developed grade II or III in 11 patients and moderate MS in 3. Three patients required reoperation for valve-related complications. The actuarial freedom from recurrent MR, MS, and reoperation were 64$\pm$11%, 86$\pm$8%, and 89$\pm$7% respectively. Conclusion: Combined mitral valve repair with AVR offers good early and long-term survival, and adequate techniques and selection of indication of mitral valve repair, especially in rheumatic disease, are prerequisites for better long-term results.