• Archives of Plastic Surgery
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• v.42 no.6
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• pp.769-775
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• 2015

Background The radial forearm flap is a versatile, widely used flap. However, the possibility of donor site complications has led to concern over its use. Some surgeons prefer using other flaps whose donor sites can be closed primarily with less morbidity, including avoiding unpleasant scarring. However, in our experience, donor site stability of the radial forearm flap can be reliably achieved by using well-implemented specific procedures. Here, we present a collection of donor site cases of the radial forearm flap and investigate factors that affect the aesthetic results as the basis for a reference for selecting a radial forearm flap. Methods In this retrospective study, we reviewed 171 cases in which a radial forearm flap was used for free tissue transfer after resecting head and neck cancer. We focused on donor site morbidity rates. Each operation involved a detailed procedure designed to minimize donor site morbidity. Moreover, statistical investigations were conducted for 22 cases to determine factors affecting the scar appearance. Results Only one case developed total skin graft necrosis as a major complication. Scar-related aesthetic results were acceptable, and the body-mass index, body weight, diabetes, and cardiac problems were significant factors related to the appearance of scars. Conclusions Performing the radial forearm flap using a well-implemented detailed technique helps achieve acceptable donor site morbidity results. The aesthetic results were more promising for patients without excess body weight, diabetes, or cardiac problems. Therefore, anxiety about donor site morbidity should not be a reason to avoid selecting the radial forearm flap in suitable patients.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1270-1275
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• 1996

Pulmonary artery aneurysms are extremely rare conditions usually associated with congenital cardiac defects that cause increased pulmonary blood flow and pulmonary hypertension. The prognosis of pulmonary artery aneurysms is fatal due to the potential for rupture of the aneurysm and the underlying severe pulmonary hypertension. A 40-year old woman was admitted to our hospital with headache following traffic accident. On admission a continuous murmur was heard over the 2nd to 3rd intercostal space along left sternal border and a calcified cystic mass at left hilar portion was incidentally discoverd on chest reontgenogram. Cardiac catherization was diagnostic of a left to right shunt at main pulmoanry artery level and pulmonary hypertension. Pulmonary angiogram demonstrated a large aneurysm of main pulmonary artery extending into proximal left pulmonary artery. The pulmonary artery aneurysm associated with patent ductus arteriosus was diagnosed definitively and the patient was underwent resection of pulmonary artery aneurysm, closure of PDA and Dacron prosthetic graft replacement under cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged without any problem.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.99-108
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• 2023

Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome. Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann-Whitney U-test. Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m² (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p < .001, p = .008). The APHCHE IV was also higher in the NRHG (p < .001). RH occurred 25.49 (7.28-52.96) hours after TTM completion, lasting for 2 (1-3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p = .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.

• The Journal of the Korea Contents Association
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• v.10 no.2
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• pp.250-257
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• 2010

This study was to analysis what factors could affect left ventricle ejection fraction(LVEF) using 64-slice multidetector CT. 164 patients(84 men, 80 women) had a cardiac CT in this study, and their blood pressure, body mass index(BMI), heart rate(HR) measured. LVEF was 52.00${\pm}$18.95% in below 25kg/$m^2$, 59.50${\pm}$16.05% in above 25kg/$m^2$ of BMI. LVEF was 57.26${\pm}$17.84% in normal blood pressure group(NBPG), 49.95${\pm}$17.63 in hypertension group(HG). LVEF was 60.76${\pm}$17.26 in below 60 beats/min, 54.14${\pm}$16.56 in 60-70 beats/min, 50.83${\pm}$20.56 in above 70 beats/min of HR. LVEF was negatively correlated with age, HR(r=-0.283 p<0.05, r=-0.231 p<0.05. respectively). And LVEF was positively correlated with BMI(r=0.228 p<0.05). A measurement of LVEF at cardiac CT by using MDCT may be considered to age, blood pressure, heart rate and BMI.

• The Journal of the Korea Contents Association
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• v.9 no.12
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• pp.339-347
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• 2009

Purpose : This study was to investigate the influence of heart rate and coronary calcification on diagnostic accuracy of 64-slice multidetector CT(MDCT) in coronary artery disease. Methods : 178 patients(84 men, 94 women) undergoing cardiac CT were included in this study. 3 coronary arteries(LAD, LCX, RCA) were assessed the presence of significant stenosis($\geq50%$) and the results compared with those of coronary angiography. Results : On a patient-based analysis, the diagnostic accuracy of 64-slice MDCT was 96.6%. The diagnostic accuracy on left anterior descending, left circumflex, right coronary artery were 86.5%, 84.3%, 92.1% respectively. Body mass index and blood pressure were not influenced on diagnostic accuracy of 64-slice MDCT. In less than 60/min of heart rate, accuracy was 90.1% and $\kappa$ value was 0.78. While in more than 70/min of heart rate, accuracy was 75.8% and $\kappa$ value was 0.52. In less than 100 of coronary calcification, accuracy was 91.3% and $\kappa$ value was 0.81. While in more than 400, accuracy was 68.6% and $\kappa$ value was 0.33. Conclusion : 64-slice MDCT shows similar diagnostic accuracy as coronary angiography. But in the context of more than 70/min of heart rate and 400 of coronary calcification, diagnostic accuracy was decreased. So there needs to identify heart rate and coronary calcification in cardiac CT, and if heart rate shows more than 70/min, use beta-blocker to regulate it.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.574-577
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• 2007

Primary malignant neoplasm of the pericardium is very rare, Neoplastic involvement of the pericardium may result in rapidly developing hemorrhagic effusion. A 30-year-old male who occasionally suffered from chest tightness was referred to our hospital under the diagnosis of unstable angina. He presented with acute chest pain and severe dyspnea that had developed one day previously. The diagnostic investigations such as echocardiography, chest CT and magnetic resonance image suggested cardiac tamponade that was caused by rupture of the pericardial teratoma. An operation to remove the tumor and effusion was performed. The pericardial mass was completely excised, and the result of the frozen biopsy favored malignancy. The final pathologic report was malignant fibrosarcoma of the pericardium and no malignant cells were found on the cytology of the pericardial effusion. The patient had a smooth postoperative course and was referred to another hospital for additional radiation therapy. We report here on this case of cardiac tamponade that was caused by primary pericardial fibrosarcoma, and this required urgent diagnosis and surgical management.

• Korean Journal of Radiology
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• v.24 no.12
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• pp.1221-1231
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• 2023

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

• Journal of Haehwa Medicine
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• v.8 no.2
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• pp.383-397
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• 2000

Background/Aims: Dong-Moo Lee Jae-Ma(1837-1900) confirmed the sasangchaejil theory based on the sasang-medicine. This theory has been the main-stem of oriental medicine during 100 years in Korea. But rarely anyone has tried to prove this theory systemicaly. So we have a trial to clarify any relationship between the sasangchaejil and the laboratory and clinical results of mass screening tests. Methods: We evaluated the laboratory values of 280 people who had taken many clinical and laboratory tests. The laboratory examinations were complete blood count, liver and kidney function test, ultrasonogram of the abdomen and breasts, gastrofiberscope, many tumor markers body mass index, blood pressure, glucose, and electrocardiogram, etc. Results: 1) Among the 280 subjects, 187/66.8% were sowumin, 58/20.7% were taewumin and 35/12.5% were soyangin. 2) Those who reacted positive to HBsAb were 22 subjects(62.8%) in soyangin, 57.2% in sowumin and 55.1% in raewumin. But there were no significant correlations. 3) 45 subjects(72.4%) in taewumin had obesity, fatty liver and hyperlipidemia.(P<0.05) 4) 20.6% in taewumin had abnormal LFT suggesting hepatic disease. It was statistically sigificant.(P<0.05) 5) An anemic state was present in women of soyangin and sowumin mostly. Since an iron deficiency anemia is common in women, there were no significant corelations among sasangchaejil. Also urinary tract infectons were common in women. 6) 6 subjects in taewumin(10.3%) had cardiac problems, while only one case(2.8%) occured in soyangin and 7 cases(3.7%) in sowumin. Taewumin was significantly high.(P<0.05) 7) In the case of gastric disease, there was no distinguishable difference among sasangchaejil.(taewumin 37.9%, soyangin 31.4% and sowumin 35.2% rrespectively) 8) There was no significant difference beteen subjects with different blood types using sasangchaejil. Conclusions: There were some significant relationship between sasangchaejil and diseases prevalent to them by the theory of sasang-medicine. But Lee didn't considered the differences of gender, the change of body status according to the development of culture, and circumstances of their lives. Also he didn't consider the existence of infectious agents. Now more systemic study with larger populations are requied.

• Archives of Pharmacal Research
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• v.29 no.3
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• pp.241-248
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• 2006

Angiotensin converting enzyme (ACE) inhibitors have cardioprotective effects in different species including human. This cardioprotective effect is mainly due to the inhibition of bradykinin (BK) degradation rather than inhibition of the conversion of angiotensin I to angiotensir. II. Bradykinin, a nonapeptide, has been considered to be the potential target for various enzymes including ACE, neutral endopeptidase 24.11, carboxypeptidase M, carboxypeptidase N, proline aminopeptidase, endopeptidase 24.15, and meprin. In the present study, the coronary vascular beds of Sprague Dawley rat isolated hearts were perfused (single passage) with Krebs solution alone or with different concentrations of BK i.e. $2.75{\times}10^{-10},\;10^{-7},\;10^{-6}\;and\;10^{-5}M$ solution. Percent degradation of BK was determined by radioimmunoassay. The degradation products of BK after passing through the isolated rat-hearts were determined using RP-HPLC and mass spectroscopy. All the four doses of BK significantly decreased the perfusion pressure during their passage through the hearts. The percentage degradation of all four doses was decreased as the concentration of drug was increased, implying saturation of a fixed number of active sites involved in BK degradation. Bradykinin during a single passage through the hearts degraded to give [1-7]-BK as the major metabolite, and [1-8]-BK as a minor metabolite, detected on HPLC. Mass spectroscopy not only confirmed the presence of these two metabolites but also detected traces of [1-5]-BK and arginine. These findings showed that primarily ACE is the major cardiac enzyme involved in the degradation of bradykinin during a single passage through the coronary vascular of bed the healthy rat heart, while carboxypeptidase M may have a minor role.

• Journal of Life Science
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• v.34 no.1
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• pp.1-8
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• 2024

Brain-type natriuretic peptide (BNP) is a cardiac hormone that exerts cardiovascular and renal effects and regulates metabolic processes. In the current study, to determine the hepatic effects of BNP, we investigated whether it improves high-fat diet (HFD)-induced hepatic IR and characterized its possible mechanism. No significant differences in body weight, fat mass, or lean mass were observed between the saline- and BNP-treated groups of normal diet-and HFD-fed mice. During the clamp test, the BNP infusion into HFD-fed mice led to lower blood glucose levels and increased glucose infusion rates versus that into saline-treated HFD-fed mice. The BNP infusion also inhibited hepatic glucose production and decreased hepatic triglyceride levels concomitant with decreased expression of gluconeogenesis and lipogenesis-related genes, resulting in reduced levels of alanine aminotransferase and aspartate aminotransferase. BNP increased the phosphorylation of Akt and AMP-acti- vated protein kinase (AMPK) in the livers of HFD-fed mice compared to saline-fed HFD mice. The incubation of AML12 murine hepatocytes with BNP increased the basal levels of phosphorylated Akt and AMPK and recovered the phosphorylated Akt and phosphorylated AMPK levels reduced by palmitate treatment. Furthermore, BNP incubation prevented palmitate-induced increases in lipo- genesis gene expressions. Taken together, the current study's findings indicated that BNP ameliorates hepatic IR, resulting in reduced hepatic glucose production and hepatic steatosis.