• Journal of Chest Surgery
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• 제37권5호
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• pp.448-451
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• 2004

개심술 후 폐색전증을 동반한 우심방 혈전의 발생 예는 매우 드물다. 10개월 전 심방중격결손 수술을 받았던 54세 여자 환자가 좌측 흉막통과 호흡곤란을 주소로 응급실에 내원하였다. 폐관류주사 검사에서 다발성 분절성 관류 결손 소견을 보였고 경식도 초음파 검사에서 우심방 벽에 위치하는 크고 줄기가 있는 움직이는 종괴가 발견되었다. 헤파린 치료 시작 13일 후 시행한 심초음파 검사에서 크기가 전혀 줄어들지 않아 개심술하에 종괴를 제거하였다. 병리 소견에서 우심방 기질성 혈전으로 밝혀졌고, 수술 후 환자는 별 문제 없이 회복되었으며 퇴원 후 와파린 치료를 받고 있다.

• 한국임상수의학회지
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• 제31권4호
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• pp.303-306
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• 2014

본 증례는 호흡곤란, 기침과 식욕결핍으로 내원한 세 마리의 요크셔테리어 개 (12년령, 13년령, 15년령)를 대상으로 하였다. 실험실적 검사 상 특이소견은 없었다. 그러나 흉부 방사선 검사상 세 마리에서 모두 심저부위의 종괴를 확인할 수 있었고, 기관지의 상승과 대동맥 융기를 확인할 수 있었다. 복부 방사선 검사 시 특이 소견은 관찰할 수 없었다. 초음파 검사상 균질한 고 에코의 종괴가 대동맥 주위에서 확인되었고 이첨판 역류를 확인할 수 있었다. 복부초음파 검사 상 특이소견은 관찰할 수 없었다. 컴퓨터 단층 촬영 결과 경계가 명확한 종괴를 좌측 앞대정맥에서 확인할 수 있었다. 종괴의 크기는 대략 $3{\times}4cm$였고 조영 증강을 확인할 수 있었다. 이상의 검사를 바탕으로 심저부 종양으로 진단하였다. 치료를 위해 심부전과 기관 허탈에 대한 대증 처치를 실시하였다. 진단 후 증례 1 (12년령)은 3 개월, 증례 2 (13년령)는 5개월, 증례 3 (15년령)은 32개월동안 생존하였다. 본 증례는 심저부 종양으로 의심되는 개에서의 임상증상, 흉부 방사선 검사, 컴퓨터 단층 촬영과 대증 처치에 대한 보고이다.

• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.278-283
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• 2004

원발성 폐평활근육종은 아주 드문 종양으로 대부분 전이된 예로 나타난다. 저자들은 좌폐상엽과 하엽에 연하여 발생한 종괴와 좌심방과 좌심실에 전이된 소견을 보이는 종괴를 관찰후 진단적 개흉술을 통한 조직검사로 진단하고 전이여부에 대한 검사를 시행한 결과 현저한 파골세포 모양의 거대세포로 구성된 원발성 폐평활근육종의 심장내 전이로 진단된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제47권3호
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• pp.233-239
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• 2014

Background: As hypertrophied myocardium predisposes the patient to decreased tolerance to ischemia and increased reperfusion injury, myocardial protection is of utmost importance in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS). Methods: Consecutive 314 patients (mean age, $62.5{\pm}10.8$ years; 143 females) with severe AS undergoing isolated AVR were included. Postoperative myocardial injury (PMI) was defined as 1) maximum postoperative creatinine kinase isoenzyme MB or troponin-I levels ${\geq}10$ times of reference, 2) postoperative low cardiac output syndrome or episodes of ventricular arrhythmia, or 3) left ventricular ejection fraction of less than 55% and decrease in left ventricle (LV) ejection fraction of more than 20% of the baseline value. Results: There were 90 patients (28.7%) who developed PMI. There were five cases of early death (1.6%), all of whom had PMI. On multivariable analysis, the use of histidine-tryptophan-ketoglutarate (HTK) solution instead of blood cardioplegia (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.63 to 5.77; p=0.001), greater LV mass (OR, 1.04; 95% CI, 1.01 to 1.07; p=0.007), and increased cardiac ischemic time (OR, 1.13; 95% CI, 1.05 to 1.22; p<0.001) were independent predictors for PMI. Patients who had PMI showed significantly inferior long-term survival than those without PMI (p=0.049). Conclusion: PMI occurred in a considerable proportion of patients undergoing AVR for severe AS and was associated with poor long-term survival. HTK cardioplegia, higher LV mass, and longer cardiac ischemic duration were suggested as predictors of myocardial injury.

• 한국임상수의학회지
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• 제25권3호
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• pp.187-191
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• 2008

A 7-year-old, intact female Yorkshire terrier dog was presented for coughing, anorexia, chest pain and dyspnea. Right lateral thoracic radiograph demonstrated a large mass shape on the heart base with decreased cardiac silhouette and severe right deviation of the trachea with the heart shifted to the left thoracic wall was observed on the ventrodorsal thoracic projection. Echocardiographic examination revealed a large rounded mass compressing left atrium around the heart base without signs of pericardial effusion. On computed tomographic (CT) findings, sagittal CT images depicted the possibility of cranial vena caval invasion and heart base involvement of the mass associated with biatrial compression. Dorsal CT image revealed the right deviation of trachea due to the heart base mass and markedly shrunk lung space was detected on the transverse CT image. Because the dog suddenly had died during the recovery from anesthesia after finishing CT scan, necropsy was performed. On gross findings, a large and lobulated mass was located at the base of the heart. A poorly-demarcated, infiltrative, multilobulated tumor composed of polyhedral cells in solid cellular sheets was confirmed based on histopathologic examination. This dog was diagnosed as a chemodectoma. This case report describes the clinical findings, diagnostic consistency of thoracic radiography, echocardiography and CT, and histopathologic confirmation in a spontaneously occurring chemodectoma with a Yorkshire terrier dog.

• 지역사회간호학회지
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• 제8권2호
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• pp.262-276
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• 1997

This study evaluates the relationship between health belief. self-efficacy and exercise and diet compliance in coronary heart disease patients. The study subjects were 96 CHD patients who visited the outpatient clinic at 3 general hospitals in Taegu city from April 3, 1997 to May 3, 1997. Data was collected by the researcher and two registered nurses who work at a cardiac outpatient clinic. Face-to-face interview was conducted. Moon's health belief scale(l990) and Hicky and others' Cardiac Diet Self-Efficacy Instrument (CDSEI, 1992), Cardiac Exercise Self-Efficacy Instrument (CESEI, 1992) were used. The instrument developed by the researcher based on the reference review was used to measure exercise and diet compliance. The data were analyzed by using descriptive statistics, Pearson correlation coefficient, t-test, ANOVA, Tukey verification and Stepwise multiple regression with the SAS program. The results of this study were as follows; 1. The degree of health belief(score range: 1-4) perceived benefit: 3.06 barrier: 2.04 severity: 2.93 2. The degree of self-efficacy(score range: 1-5) exercise self-efficacy: 2.91 diet self-efficacy: 3.32 3. The degree of compliance (score range: 1-4) exercise compliance: 2.34 diet compliance: 2.95 4. The exercise compliance had a positive correlation with perceived benefit(r=0.5327, p=0. 0001), severity(r=0.2780, p=0.0061), exercise self-efficacy(r=0.6675, p=0.0001), and a negative correlation with barrier{r= -0.4236, p=0.0001). The diet compliance had a positive correlation with perceived benefit (r=0.6439, p=0.0001), severity(r=0.4244, p=0.0001), diet self-efficacy(r=0.6629, p=0.0001), and a negative correlation with barrier{r= -0.5098, p=0.0001). 5. According to pt's education level, (F=3.02, p=0.0336), received massage from mass media on exercise and diet(t=3.81, p=0.0002), presence of cardiac patients in the family members or friends(t=2.00, p=0.0478), created significant differences in exercise compliance. According to occuption(F=3.03, p=0.0215), hospitalized experience(t=4.59, p=0.0000), presence of chest pain(t=3.63, p=0.0005), there was also a significant difference in diet compliance. 6. The combination of exercise self-efficacy, perceived benefit and pt's education level explained 50.18% of the variance in exercise compliance. The combination of diet self-efficacy, perceived benefit and barrier explained 56.76% of the variance in diet compliance. On the basis of the above findings, the follow ing recommendations are suggested: 1. To promote the exercise. diet compliance for CHD patients, a well organized health teaching and nursing intervention program should be developed. 2. More research is needed to investigate other variables affecting exercise and diet compliance of CHD patients. 3. To promote self-efficacy and a positive health belief in CHD patients, a well organized and an approachable nursing intervention program should be developed. 4. Factors other than diet. exercise compliance should be evaluated to discover the impact on CHD patients.

• Korean Journal of Radiology
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• 제22권10호
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• pp.1619-1627
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• 2021

Objective: This study used cardiac magnetic resonance imaging (MRI) to compare the characteristics of left ventricular remodeling in patients with primary aldosteronism (PA) with those of patients with essential hypertension (EH) and healthy controls (HCs). Materials and Methods: This prospective study enrolled 35 patients with PA, in addition to 35 age- and sex-matched patients with EH, and 35 age- and sex-matched HCs, all of whom underwent comprehensive clinical and cardiac MRI examinations. The analysis of variance was used to detect the differences in the characteristics of left ventricular remodeling among the three groups. Univariable and multivariable linear regression analyses were used to determine the relationships between left ventricular remodeling and the physiological variables. Results: The left ventricular end-diastolic volume index (EDVi) (mean ± standard deviation [SD]: 85.1 ± 13.0 mL/m² for PA, 75.9 ± 14.3 mL/m² for EH, and 77.3 ± 12.8 mL/m² for HC; p = 0.010), left ventricular end-systolic volume index (ESVi) (mean ± SD: 35.2 ± 9.8 mL/m² for PA, 30.7 ± 8.1 mL/m² for EH, and 29.5 ± 7.0 mL/m² for HC; p = 0.013), left ventricular mass index (mean ± SD: 65.8 ± 16.5 g/m² for PA, 56.9 ± 12.1 g/m² for EH, and 44.1 ± 8.9 g/m² for HC; p < 0.001), and native T1 (mean ± SD: 1224 ± 39 ms for PA, 1201 ± 47 ms for EH, and 1200 ± 44 ms for HC; p = 0.041) values were higher in the PA group compared to the EH and HC groups. Multivariable linear regression demonstrated that log (plasma aldosterone-to-renin ratio) was independently correlated with EDVi and ESVi. Plasma aldosterone was independently correlated with native T1. Conclusion: Patients with PA showed a greater degree of ventricular hypertrophy and enlargement, as well as myocardial fibrosis, compared to those with EH. Cardiac MRI T1 mapping can detect left ventricular myocardial fibrosis in patients with PA.

• Clinical and Experimental Pediatrics
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• 제58권3호
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• pp.108-111
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• 2015

DiGeorge syndrome is an immunodeficient disease associated with abnormal development of 3rd and 4th pharyngeal pouches. As a hemizygous deletion of chromosome 22q11.2 occurs, various clinical phenotypes are shown with a broad spectrum. Conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcemia are the classic triad of DiGeorge syndrome. As this syndrome is characterized by hypoplastic or aplastic thymus, there are missing thymic shadow on their plain chest x-ray. Immunodeficient patients are traditionally known to be at an increased risk for malignancy, especially lymphoma. We experienced a 7-year-old DiGeorge syndrome patient with mediastinal mass shadow on her plain chest x-ray. She visited Severance Children's Hospital hospital with recurrent pneumonia, and throughout her repeated chest x-ray, there was a mass like shadow on anterior mediastinal area. We did full evaluation including chest computed tomography, chest ultrasonography, and chest magnetic resonance imaging. To rule out malignancy, video assisted thoracoscopic surgery was done. Final diagnosis of the mass which was thought to be malignancy, was lymphoproliferative lesion.

• Journal of Chest Surgery
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• 제34권10호
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• pp.787-791
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• 2001

관상동맥류는 매우 드문 질환으로, 통상적으로 주위 정상 분절보다 내경이 1.5배 이상 초과하여 비정상적으로 확장되어 있는 경우로 정의된다. 유병률은 백인종에서는 2.6%, 동양인에서는 0.25%로, 전자는 약 반수이상이 죽상경화성 관상동맥질환과 관련되어 있으나, 후자는 70% 정도가 비폐쇄성 동맥류와 관련되어 있는 것으로 보고 된 바 있다. 관상동맥루 또한 매우 드문 질환으로, 10년간 실시한 심혈관조영촬영술에서 단지 0.2% 만이 발견되었다고 보고된 바 있다. 증상은 없을 수도 있고, 무증상적 심잡음, 운동시 호흡 곤란, 피로감, 울혈성 심부전 등으로 나타날 수 있다. 주침범 관상동맥은 우관상동맥(56%), 좌관상동맥(36%) 순이고, 원위부 연결 부위는 우심실(39%), 우심방(33%), 폐동맥(20%)으로 보고된 바 있다. 저자들의 경우 단순흉부사진과 흉부전산화단층촬영상 종격동 종양이 의심되어 좌측전측방 개흉술로 종양제거를 시도했다. 그러나 종양은 좌실실에서 기원하고, 수술 중 실시한 거대종괴(6$\times$6$\times$6cm)내 바늘흡입검사 상 박동성의 동맥혈이 분출하여서, 심장 박동 중에 제거하는 것이 매우 위험하다고 판단되어 수술을 계속 진행하지 않았다. 개흉술 4일 후 실시한 심혈관조영술 상 첫사선관상동맥(1st diagonal artery)에서 혈류를 받는 심장종양이 의심되었고, 상행대동맥에서 총폐동맥간으로 연결되는 관상동맥루가 우연히 발견되었다. 정중흉골절개술 후, 체외순환 하에서 종양 제거술과 관상동맥루 결찰술을 성공적으로 실시하였다. 수술후 병리 조직소견상 심장종양이 아닌 관상 동맥류로 판명되었으며 수술 후 합병증 없이 경쾌 퇴원하였다.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.124-128
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• 2018

Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical repair or percutaneous device closure. Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by transesophageal echocardiography revealed a mobile mass at the patch repair site in the left atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation. Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to consider cardioembolic source as being part of the etiology of stroke recurrence, even if the event occurs many years after intracardiac shunt closures.