• Journal of Chest Surgery
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• v.5 no.1
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• pp.19-24
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• 1972

The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.964-970
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• 1996

One hundred eight patients (Feb.'86, through Jan.'96) underwent 53 mitral(MVR), 20 aortic(AVR), )5 double(DVR) valve replacement with SJM prosthesis. There were 55 males and 53 females whose mean age was 36.3 $\pm$ 10.4 years. We used 143 valves in mitral(88), aortic(54), and tricuspid(1) sites. The size and number of valves were 31 mm(32). 33inm(23), 29mm(20), 27mm(10), 25mm(2), and 35mm(1) in mitral site; 2)mm(21), 21mm(1 S), 19mm(7), 25mm(5), 27mm(2), and 33mm(1) in aortic site; and Blmm(1) in tricuspid site. Preoperative NYHA functional classes were II(14), III(73) and IV(21), and which were improved into I(89) and II(16) postoperatively. Early postoperative complications occurred in 15 cases(13.9%) in which LOS was the most common one(5 cases; 4.6%). fatly hospital death occurred in 3 cases(2.8%) due to LOS(1) and sudden cardiac arrest(2) he cummulative total follow-up period was 437.6 pl-yr with a mean of 4.1$\pm$2.9 years. There were 5 events of valve related'complications (2 TE, 1 paravalvular leak, 1 TE+paravalvular leak, 1 PVE) with the occurrence rate as 1.14%/pt-yr. Reoperation was performed in 2 cases and there were 2 cases of valve related death due to one PVE and one paravalvlllar leak. The complication free rate was 91.4$\pm$ ).4% at 10 years. Actuarial survival rate was 93.6 $\pm$ 3.1 % at 10 years.

• Journal of Biomedical Engineering Research
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• v.38 no.6
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• pp.313-320
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• 2017

Myocardial infarction is a disease caused by stenosis of the coronary arteries. The high risk of sudden cardiac death due to myocardial infarction has triggered related researches that have been actively studied so far. However, these studies focused on the clinical results, which are mainly based on observations of symptoms due to infarction through electrocardiograms. Therefore, in this study, we tried to analyze the behavior of heart according to the position and volume of infarction lesion through the computer simulation study using three dimensional ventricular models. In order to implement infarction, commercial software was used to simulate cell necrosis due to blockage of a specific coronary. In addition, the conduction block due to infarction was mimicked by reducing the electrical conduction in the infarcted area, which was 100 times less than the electrical conduction of the whole ventricular lattice implemented by the finite element analysis method. Thus, this study classified the infarcted cases into the upper, middle, lower, and apex according to lattice data of eight different infraction areas. In other words, we assumed that myocardial infarction would have inherent electro-dynamic characteristics depending on the location and extent, and analyzed the ventricular electromechanical responses for infarction lesions using a three dimensional cardiac physiome model. The results showed that the volume of infarction did not directly affect the cardiac responses, but the location of the infarction lesions could influence the ventricular pumping efficiency. These suggest that the occlusion of specific coronary arteries may have a fatal effect on the decline in ventricular performance. In conclusion, although location of myocardial infarction lesions is considered to be an important variable to be considered clinically rather than lesion size, quantitative predictions should be made more in the future considering physiological factors such as lesion location and direction of myocardial fiber at that location.

• Korean Journal of Veterinary Research
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• v.27 no.2
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• pp.277-290
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• 1987

This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.

• Korean Journal of Veterinary Research
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• v.30 no.4
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• pp.441-446
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• 1990

Encephalomyocarditis virus infection in pigs, characterized by severe reproductive failure in sows and sudden death in less than 7 day-old-piglets, a period of several months from October to December of 1989, in Korea was occurred. The most outstanding gross lesions at necropsy were found in the heart which were consisted of pale, yellow brown necrotic foci of varying size in myocardium. In some cases, pulmonary edema and liver congestion were observed. Histopathology of the heart revealed the interstitial myocarditis, endocarditis and epicarditis with lymphocytic, plasmacytic and macrophage cell infiltration and, in some cases, calcification of the necrotic myocardial muscle fibers. In some cases of brain, the perivascular cuffing and glial nodules were observed. In the liver and the lacrimal gland varying degrees of multifocal necrosis were seen. The virus was isolated from the heart and the brain in a stillborn piglet and a mummified fetus. This outbreak represents the first case of encephalomyocarditis virus infection of pigs in Korea.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1238-1242
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• 1998

Myocardial bridges as an anatomical arrangement in which an epicardial coronary artery becomes engulfed, for a limited segment, by myocardial fibers. These diseases are recognized primarily because of their systolic narrowing or milking effect as seen on coronary angiography. The most frequent site of myocardial bridging is the middle segment of left anterior descending artery. Myocardial bridges have an ischemic effect capable of causing : angina pectoris, myocardial infarction, ventricular fibrillation, or even sudden death in athletes. We report 2 patients having a milking effect of the middle segment of left anterior descending artery who were suffered from angina. The operation procedure was a simple supraarterial myotomy over the embedded segment of the LAD under cardiopulmonary bypass. Angina and milking effect were disappeared after the operation.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.155-160
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• 2020

Torsades de pointes refers to polymorphic ventricular tachycardia (PMVT), which is caused by the suppression of potassium channels owing to genetic and electrolytic abnormalities, resulting in the extension of the QT interval. Symptoms range from spontaneous circulation recovery to fainting and sudden death. Defibrillation, magnesium correction, and the use of lidocaine as an antiarrhythmic agent are recommended as treatments for persistent torsades de pointes. Currently, only amiodarone is available in the ambulance; however, torsades de pointes does not respond efficiently to amiodarone because it suppresses potassium channels and increases the refractory period of the myocardium. Lidocaine, in contrast, reduces the relative refractory period of the myocardium caused by suppressing sodium channels; thus, it inhibits the occurrence of and treats arrhythmia. In cases where PMVT did not respond to defibrillation, the administration of lidocaine showed no difference in survival and discharge rates compared to amiodarone. Thus, ambulances must be equipped with provisions to administer lidocaine.

• Journal of Pharmacopuncture
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• v.3 no.2
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• pp.1-25
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• 2000

We were trying to study the validity of Puffer fish's poison(Tetrodotoxin- TTX) to make a traditional Korean Medical treatment. The following conclusions were made after literary studies. 1. The first record of the puffer fish dates back 2000 years ago in the Chinese text Book of Mountain and Sea and other texts from the similar period. 2. Puffer fish's poison IS known as tetrodotoxin which is an amino perhydroquinazoline compound. It has a chemical formula of $C_{11}H_{17}N_3O_8$ in the hemiacetal structure and has the molecular weight of 319. 3. Tetrodotoxin (TTX) plays a role as potent neurotransmitter blocker by blocking the $Na^+$ -gate channel which hinders the influx of $Na^+$ ion into the cell. 4. Symptoms of the puffer fish poisoning ranges from blunted sense in the lips and tongue, occasional vomiting in the first degree to sudden descending of the blood pressure, apnea, and other critical conditions in the fourth degree. Intoxication of the puffer fish poison progresses at a rapid pace as death may occur after an hour and half up to eight hours in maximum. Typical death occurs after four to six hours. 5. Ways to treat the puffer fish poisoning include gastric irrigation, induce vomiting, purgation, intravenous fluid injection, and correcting electrolytic imbalance and acidosis. In cases of dyspnea, apply oxygen inhalation and conduct artificial respiration. 6. Tetrodotoxin (TTX) may be applied in treating brain disorders, ocular pain, excess pain in the large intestine and ileum, and relieving tension of the skeletal museles, neuralgia, rheumatism, arthritis, and etc. 7. In terms of Oriental medicine, the puffer fish poison has characteristics of sweet, warm, and poisonous. It's known efficacies are to tonify weakness, dispel damp, benefit the lower back, relieve hemorrhoid, kills parasites, remove edema, and so forth. And the puffer fish eggs processed with ginger are said to be effective against tuberculosis and lung cancer, thus, it's validity must be investigated and further research should be followed.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.304-307
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• 1998

Aneurysm of the sinus of Valsalva on mostly congenital disease that develops more frequently in Orientals, is very low in incidence. In most cases, aneurysm of the sinus of Valsalva extends to intracardiac and results in ruptures into the right ventricle or atrium. The likelihood of extracardiac aneurysm of the sinus of Valsalva is very low. Cases of extracardiac aneurysm are usually accompanied by aortic regurgitation and can cause right ventricle outflow tract obstruction, myocardial ischemia, and myocardial infarction due to compression by aneurysm. Since the aneurysm can rupture in the intrapericardium and cause cardiogenic shock or sudden death, definite diagnosis and management are important. If confirmed, it is preferable operform a surgical correction. We report here, with a literature review, a case where myocardial ischemia and aortic egurgitation caused by aneurysm developed in the left coronary and noncoronary sinus, and were surgically corrected with satisfactory esults.

• Korean Journal of Veterinary Research
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• v.45 no.3
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• pp.369-373
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• 2005

A male mixed breed dog with unknown age (case 1) and 5-year-old female golden retriever (case 2) were admitted to the Department of Veterinary Pathology at College of Veterinary Medicine, Seoul National University after sudden death. At necropsy, stifle region of case 1 was replaced by coalescing firm tan nodules approximately 1-3 cm in diameter. Neoplastic nodules were also presented in the lung. In case 2, the spleen was enlarged 3-5 times its normal size and numerous firm tan nodules were noted in the kidney, pericardium, diaphragm and lymph nodes. Histopathologically, the neoplastic masses of case 1 consisted of plump spindle cells having abundant cytoplasm and indistinct cell borders that formed interlacing bundle. In case 2, the masses were consisted of round to polygonal cells with abundant eosinophilic cytoplasm and eccentric nuclei. Numerous multinucleated giant cells containing nuclei of various sizes were noted. Immunohistochemically, neoplastic cells of all two cases stained intensely with vimentin and lysozyme. Based on the gross and light microscopic findings together with immunohistochemistry, both cases were diagnosed as localized histiocytic sarcoma with pulmonary metastasis and disseminated histiocytic sarcoma, respectively.