• 보험의학회지
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• 제31권1호
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• pp.10-14
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• 2012

The importance of the diseases which are differentiated with acute myocardial infarction (AMI) cannot be overemphasized in insurance medicine. Although there are lots of diseases similar with AMI, in this paper, 5 diseases were described; Myocardial bridging, cocaine toxicity, myocarditis, cardiac syndrome X, and Takotsubo syndrome. Costs of the interventions like coronary angiography or echocardiography are relatively low in Korea compared to western countries. Therefore, detection of those diseases has been increased recently and illegal drug addiction also has been increased probably due to globalization. In conclusion, the knowledge of those diseases dealt with this article could be helpful for the person who is related to insurance medicine.

• Journal of Chest Surgery
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• 제21권6호
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• pp.1052-1059
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• 1988

297 cases of military personnel and 7 cases of civilian were operated in K.A.F.C.H. from January 1982 to October 1988 due to cardiovascular disease, which consist of 202 cases [66.4%] of vascular disease, 91 cases [29.9%] of cardiac disease, and 11 cases [3.6%] of pericardial disease. Mean age was 25.8*7.2[2S.D.] year of age and nearly all patients were male except 4 cases of female patient in civilian. Of the 253 cases [83.2%] of acquired disease, vascular diseases were 149 cases [583%], traumatic cardiovascular 54 [21.3%], cardiac 40 [15.8%], and pericardial 10 [4.0%]. Of the 51 cases [16.8%] of congenital diseases, cardiac anomalies were 48 cases [94.1%], vascular 2 [3.9%] and pericardial 1 [2.0%]. Open heart surgery was done in 83 cases of cardiac disease, which consists of 39 cases [46.9%] of valvular heart disease, 22 cases [26.59o] of ASD, 14 cases [16.9%] of VSD, 2 cases [2.4%] of partial ECD, and so on. Of the 6 cases [2.0%] of over-all mortality, operative death in open heart surgery was 4 cases[4.8%].

• The Korean Journal of Physiology and Pharmacology
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• 제26권5호
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• pp.335-345
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• 2022

Pyroptosis is an inflammatory form of programmed cell death that is linked with invading intracellular pathogens. Cardiac pyroptosis has a significant role in coronary microembolization (CME), thus causing myocardial injury. Tanshinone IIA (Tan IIA) has powerful cardioprotective effects. Hence, this study aimed to identify the effect of Tan IIA on CME and its underlying mechanism. Forty Sprague-Dawley (SD) rats were randomly grouped into sham, CME, CME + low-dose Tan IIA, and CME + high-dose Tan IIA groups. Except for the sham group, polyethylene microspheres (42 ㎛) were injected to establish the CME model. The Tan-L and Tan-H groups received intraperitoneal Tan IIA for 7 days before CME. After CME, cardiac function, myocardial histopathology, and serum myocardial injury markers were assessed. The expression of pyroptosis-associated molecules and TLR4/MyD88/NF-κB/NLRP3 cascade was evaluated by qRT-PCR, Western blotting, ELISA, and IHC. Relative to the sham group, CME group's cardiac functions were significantly reduced, with a high level of serum myocardial injury markers, and microinfarct area. Also, the levels of caspase-1 p20, GSDMD-N, IL-18, IL-1β, TLR4, MyD88, p-NF-κB p65, NLRP3, and ASC expression were increased. Relative to the CME group, the Tan-H and Tan-L groups had considerably improved cardiac functions, with a considerably low level of serum myocardial injury markers and microinfarct area. Tan IIA can reduce the levels of pyroptosis-associated mRNA and protein, which may be caused by inhibiting TLR4/MyD88/NF-κB/NLRP3 cascade. In conclusion, Tanshinone IIA can suppress cardiomyocyte pyroptosis probably through modulating the TLR4/MyD88/NF-κB/NLRP3 cascade, lowering cardiac dysfunction, and myocardial damage.

• 한국정보과학회논문지:소프트웨어및응용
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• 제36권10호
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• pp.825-835
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• 2009

의학기술이 발전하면서 결핵, 폐렴, 영양실조, A형간염 등의 질병에 의한 사망률은 감소하는 반면, 심장 질환으로 인한 사망률은 증가하는 추세이다. 심장병을 예방하기 위하여 정기적인 검사가 중요하고, 인체에 무해한 자기공명영상을 활용하여 심장의 혈류량과 심박구출률을 계산하여 심장의 기능을 분석할 필요가 있다. 본 논문에서는 기존의 노동집약적이고 시간적 비용이 큰 수동윤곽분할을 대체하기 위한 자동 좌심실 분할 알고리즘을 제안하였다. 방사형 임계치 결정법을 통하여 심실을 분할하고 혈류량 및 심박구출률을 계산하였으며, 특히 기존 방법들에서 문제가 되었던 기저 영상도 사용자 간섭률을 최소화하여 자동분할을 수행하였다. 제안 알고리즘의 검증을 위하여 36명의 심장 자기공명영상 데이터를 사용하여 전문가에 의한 수동윤곽분할 및 제너럴일렉트로닉스 MASS 소프트웨어와 정량적 비교를 수행하였다. 실험을 통해 제안한 방법이 표준으로 간주되는 수동윤곽분할과 정확도가 유사하며, MASS 소프트웨어보다 높은 정확도를 갖고 있음을 알 수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.332-340
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• 2022

Background: Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period. Methods: We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation. Results: Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292). Conclusion: Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.

• 대한핵의학회지
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• 제13권1_2호
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• pp.7-14
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• 1979

Radionuclide cardiac angiography has distinct advantages in safety, patient comfort, cost and ease of performance. This method offers diagnostic accuracy equivalent to that of cardiac catheterization. By this method the qualitative and quantitative diagnosis of the cardiac shunts are available. Also for it is repeatable with ease and more physiologic, it has application in following pre- and post-operative shunt patients. We performed the radionuclide cardiac angiographies in 147 cases of heart diseases and 26 cases of normal group. 1. The detection of left-to-right shunt was possible in 22 of 24 patients, and 2 patients were not diagnosed due to small shunt amount. (Qp/Qs<1.3) In 21 patients of right-to-left shunt, all were diagnosed by radionuclide cardiac angiography. 2. With the pulmonary time-activity curve, $C_2/C_1$ ratio was calculated. In normal control group, a range of $C_2/C_1$ ratios of $21{\sim}38%$ was established with a mean value of $28.6{\pm}4.6%$. In patients with left-to-right shunts determined by catheterization data, the range of $C_2/C_1$ ratio was $33{\sim}90%$, with a mean value of $67.8{\pm}12.2%$. 3. In 8 cases of left-to-right shunt, $Q_p/Q_s$ ratios determined by radionuclide cardiac angiography were compaired with those of cardiac catheterization. The correlation coefficient was 0.907. (P<0.001) 4. Postoperative radionuclide cardiac angiographies were done in 21 cases. 3 of 13 patients with left-to-right shunts were found to have residual shunts. 8 patients with right-to-left shunts were confirmed to have no residual shunt.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2006년도 제45차 춘계학술대회
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• pp.51-52
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• 2006

• Journal of mucopolysaccharidosis and rare diseases
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• 제4권1호
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• pp.21-25
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• 2018

Fabry disease is a hereditary lysosomal storage disorder caused by the reduction or absence of lysosomal enzyme alpha-galactosidase A and the accumulation of glycosphingolipids, such as globotriaosylceramide (Gb3), in various organs, including the heart. The prevention of cardiac involvement in Fabry disease can only be achieved by enzyme replacement therapy (ERT), and the method of assessing the efficacy of ERT should be confirmed. Changes in the electrocardiogram, such as the shortening of PQ interval, prolongation of QTc and repolarization abnormalities as well as left ventricular hypertrophy in voltage criteria, can be used to identify Fabry disease patients; however, the usefulness of electrocardiograms for evaluating the efficacy of ERT is limited. The assessment of left ventricular hypertrophy using echocardiography has been established to evaluate the efficacy of ERT during long-term period. A new technique involving speckled tracking method might be useful for detecting early cardiac dysfunction and identifying the effect of ERT for a relatively short period. The estimation of left ventricular hypertrophy using cardiac magnetic resonance (CMR) is also useful for assessing the efficacy of ERT. Identifying late gadolinium enhancement in CMR may affect the effectiveness of ERT, and the new technique of T1 mapping might be useful for monitoring the accumulation of Gb3 during ERT. Histopathology in cardiac biopsy specimens is another potentially useful method for identifying the accumulation of GB3; however, the use of histopathology to evaluate of the efficacy of ERT is limited because of the invasive nature of an endomyocardial biopsy.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.401-408
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• 2012

Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

• Clinical and Experimental Pediatrics
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• 제63권4호
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• pp.151-156
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• 2020

Background: Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery. Purpose: This study aimed to investigate the clinical usefulness of these biomarkers in young children. Methods: Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated. Results: Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery. Conclusion: It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.