• The Korean Journal of Physiology
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• 제27권1호
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• pp.51-55
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• 1993

The effects of a calcium channel blocker and an activator on the release of atrial natriuretic peptide (ANP) were investigated in rats. They were volume expanded (VE) up to 5% of the body weight over 30min by being infused with iso-oncotic saline. Following VE, plasma ANP concentration markedly increased in association with increases in the right atrial pressure. Addition of either nifedipine ($0.4{\mu}m/min$) or Bay K 8644 ($0.4{\mu}m/min$) in the infusate potentiated the VE-induced release, although neither of them affected the right atrial pressure. The nifedipine added group showed a lower mean arterial pressure than the Bay K added group throughout the infusion period. VE decreased plasma renin concentration, the magnitude of which was attenuated by nifedipine but not by Bay K. It may be hypothesized that a decrease in cytoplasmic calcium is primary stimulus far the ANP release, and an increase plays o role in secondary liberation of the ANP accumulated in the interstitium into the lumen of the atria through myocardial contraction. further studies will be needed to confirm the hypothesis.

• 대한수의학회지
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• 제43권2호
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• pp.307-310
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• 2003

An atrial septal defect (ASD) is congenital heart disease with a communication between the atria, which allows blood to shoot from the atrium with pressure. A 3-month-old female Miniature Schunauzer was referred to the Veterinary Teaching Hospital of Konkuk University for the evaluation of systolic heart murmur. At presentation, the mucous membrane was cyanotic. On physical examination, an ejection-type systolic murmur was auscultated at the pulmonic area. In addition, thoracic radiography showed enlargement of main pulmonary artery and right atrial/ventricular enlargement. Echocardiography revealed dilated right atrium and atrial septal defect. However, mitral and tricuspid valve were still intact and well tolerating. The presence of an ASD was confirmed by identifying flow across the defect with color Doppler imaging. Doppler echocardiography provides a means of non-invasive documentation and quantification of ASD. Complete blood count and serum chemistry were not remarkable. Although large defect was confirmed between the two atrium, the patient did not show any obvious clinical signs of heart failure at this time.

• Journal of Chest Surgery
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• 제51권2호
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• pp.146-148
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• 2018

Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA). However, follow-up computed tomography showed residual communication, so the patient is still taking warfarin. We report that a minimally invasive strategy for treating LAA aneurysm can be considered, but incomplete closure may occur; thus, caution is needed.

• Journal of Chest Surgery
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• 제28권9호
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• pp.811-816
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• 1995

Repairs of atrial septal defect utilizing cardiopulmonary bypass were performed in 50 adults, ranging age from 16 to 53 years, since April 1986 up to October 1994. They occupied 38.8% of all adult congenital heart disease operated in the same period. Preoperatively, 16 patients were functional class II, 12 patients class III and 4 patients class IV[New York Heart Association Classification , respectively. Five patients combined with atrial fibrillation and the remainders revealed regular sinus rhythm. Cardiac catheterizations were performed in 43 out of 50 patients, and revealed a systolic pulmonary arterial pressure in excess of 51 mmHg in 4 patients but none had reversed shunt. 40 patients[80% were repaired with patch closure and remainings were repaired with direct closure. 49 patients were followed up for 2 months up to 102 months[average 55 months . A comparison of the preoperative and postoperative functional class demonstrated a mean decrease of one NYHA functional level[2.5$\pm$0.63 to 1.4$\pm$0.56 . There was no operative mortality. One patient died during the follow-up period and the death was unrelated to heart disease. Operative treatment is indicated for repair of atrial septal defect with left to right shunt in the adult patient and a considerable clinical improvement can be anticipitated with low mortality.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1046-1048
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• 1999

A life-long anticoagulation for the prevention of ischemic cerebral events by thromboemboli has been conventionally introduced for the treatment of an atrial septal aneurysm. However, due to the recent decrease of the risks in the open heart surgery, the alternative therapeutic modality has been introduced for the prevention of complications of the anticoagulation. A 41-year old female with dizziness was admitted to our hospital. She was diagnosed a shaving atrial fibrillation and a cerebellar infarction, and an atrial septal aneurysm was detected by transesophagel echocardiography that was not detected by the transthoracic echocardiography. Surgery was approached to the right submammarial anterolateral thoracotomy. The atrial septal aneurysm was obliterated by a purse-string suture and plication. Surgial results were excellent with normal sinus rhythms and esthetically satisfying appearance.

• Journal of Chest Surgery
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• 제18권2호
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• pp.273-278
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• 1985

The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

• Journal of Chest Surgery
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• 제11권3호
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• pp.348-354
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• 1978

Myxoma constitue about 50% of a II primary cardiac, tumor (incidence 0.03%) and occur in any of the cardiac chambers, but about 75% of themare found in the left atrium. As is well known, left atrial myxoma usually simulates mitral valvular disease, and it tends to bring about postural syncope and frequent embolic manifestaticns. The clinical manifestation of left atrial myxoma upon the circulation are obstructive effects, embolic effects and constitutional effects. Diagnosis is now most of all important since surgery can be dramatically curable, whereas untreated myxoma apparently invariably lead to deadful course. Preaprative diagncsis by echocardiogram is so simple and accurate for detection of myxoma that awareness of mitral valvular heart disease with rapid deterioration must be screened. We have diagnosed one case of the left atrial myxoma preopratively by phonocardiogram, echocardiogram and levophase pulmonary angiograJ;n and successfully treated by operation under extra corporeal circulation. A 38 years old housewife was admitted to the National Medical Center because of dyspnea, and paroxysmal cough on occasions for prior to hospitalization. Operation was carried out by median sternotomy and left atriotomy with mild hypothermia under E.C.C. The left atrial myxoma was extirpated including endocardial fragment and its weight was 23gm. The hospital course was not eventful and she can work nowadays without symptoms.

• 성인간호학회지
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• 제17권2호
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• pp.230-238
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• 2005

Purpose: The purposes of this study were to explore the concept of uncertainty and to examine the relationships among uncertainty, appraisal of uncertainty, depression, anxiety, and perceived health status in patients with atrial fibrillation. Method: The study utilized a descriptive correlational survey design using a face to face interview method. A convenience sample of 49 subjects were recruited from K university hospital over 8 months. The data were analyzed by t-test, ANOVA, Pearson correlation and partial correlation analysis. Results: 1) Subjects perceived with moderately high uncertainty(M=65.98); moderate physical health(M=39.80), mental health(M=47.38), and general health(M=2.94); moderate anxiety(M= 44.78); and slightly low depression(M=15.33). 2) There were significant differences in uncertainty by gender and education. 3) Uncertainty and danger appraisal were significantly correlated(r=.32, p=.03) while the uncertainty was not associated with opportunity appraisal. 4) Uncertainty was significantly correlated with mental health(r=-.31, p=.04), anxiety(r=.38, p=.01), and depression(r=.37, p=.01). Conclusion: This study was the first trial to explore uncertainty and to examine the relationships among its associated factors in Korean patients with atrial fibrillation. Thus, based on the findings of this study, directions for nursing practice and further nursing research for patients with atrial fibrillation were suggested.

• 성인간호학회지
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• 제25권1호
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• pp.13-23
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• 2013

Purpose: The purpose of this study was to investigate the factors that influence health-related quality of life in patients with atrial fibrillation. Methods: The subjects were 150 outpatients with atrial fibrillation who visited the cardiology clinic of a university hospital in U city. The instruments used for this study were Mhel Uncertainty in Illness Scale (MUIS), Center for Epidemiologic Studies-Depression Scale (CES-D), State Trait Anxiety Inventory (STAI), and the Short-Form-36 Health Survey (SF-36) Korean version II. The date were analyzed by ANOVA, Pearson-correlation coefficient, and hierachial multiple regression using SPSS/WIN 18.0. Results: The mean score of physical health-related quality of life (PCS) was $38.92{\pm}6.22$ and mental health-related quality of life (MCS) was $41.49{\pm}5.71$. Physical and Mental health-related quality of life had the significant correlations with uncertainty, anxiety and depression. In multiple regression analysis, physical health-related quality of life was significantly influenced by duration of disease, NYHA class, uncertainty. Mental health-related quality of life was significantly influenced by family income, NYHA class, anxiety and depression. Conclusion: These results suggest that these influencing factors should be consider in developing the nursing interventions to improve the healthrelated quality of life in patients with atrial fibrillation.

• Journal of Chest Surgery
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• 제21권1호
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• pp.1-9
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• 1988

The left atrial [LA] dimension and atrial fibrillation [AF] in patients with mitral valvular heart diseases have been thought to be related to hemodynamic burden to the LA depending on severity of stenosis or regurgitation of mitral valve, left ventricular contractility and the heart conditions. If hemodynamic burden persists long, it can affect the LA wall and structural change of the LA wall itself can developed. So the structural change of the LA wall could be thought to be related to the LA dimension and AF. To verify this relation, the LA wall biopsy was performed in 26 patients with rheumatic mitral valvular heart disease at the left atriotomy incision margin which was posterior to the interatrial groove after completion of surgery to the mitral valve such as valve replacement or commissurotomy. Relation of the pathological state of the LA wall to AF and the LA dimension measured by M-mode echocardiography was studied. The conclusions were as follow. 1. There was tendency that degree of fibrosis of myocardium of the LA wall was related to the LA dimension. 2. There was more chance that patients who had severe fibrosis of myocardium of the LA wall had pre and postoperative AF. 3. There was no relation between reduction rate of the LA dimension before and after surgery and degree of fibrosis of myocardium of the LA wall.