• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권5호
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• pp.432-440
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• 2022

Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m². Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m² vs. 16.06± 4.55 kg/m², p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

• 한국임상수의학회지
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• 제32권5호
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• pp.433-435
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• 2015

12년령의 중성화한 암컷 골든레트리버가 3개월간의 호흡곤란과 기력저하를 주호소로 내원하였다. 심낭삼출물과 심장부위의 종괴가 심장초음파 상에서 확인되었다. 심낭절제술과 종괴 제거가 이루어졌으며 확진을 위해 조직검사를 수행하였다. 종괴는 현미경 검사 상에서 적혈구와 피브린, 호중구로 이루어진 혈종임이 확인되었다. 염증세포와 반응성 섬유 조직에 의해 두꺼워진 중증의 화농성 심낭염 소견이 확인되었으며, 종양 소견은 관찰되지 않았다. 이 증례는 수의학에서 개의 심장혈종에 의한 심낭삼출물 발생의 최초 보고이다.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.435-441
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• 2023

Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient's body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient's inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

• Nutrition Research and Practice
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• 제6권4호
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• pp.315-321
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• 2012

We tested the effects of dietary intake of freeze-dried Korean traditional fermented cabbage (generally known as kimchi) with varying amounts of sodium on blood pressure and cardiac hypertrophy in spontaneously hypertensive rats (SHRs). Wistar-Kyoto rats (WKY), as a control group, received a regular AIN-76 diet, and the SHRs were divided into four groups. The SHR group was fed a regular diet without kimchi supplementation, the SHR-L group was fed the regular diet supplemented with low sodium kimchi containing 1.4% salt by wet weight, which was provided in a freeze-dried form, the SHR-M group was supplemented with medium levels of sodium kimchi containing 2.4% salt, and the SHR-H group was supplemented with high sodium kimchi containing 3.0% salt. Blood pressure was measured over 6 weeks, and cardiac hypertrophy was examined by measuring heart and left ventricle weights and cardiac histology. SHRs showed higher blood pressure compared to that in WKY rats, which was further elevated by consuming high sodium containing kimchi but was not influenced by supplementing with low sodium kimchi. None of the SHR groups showed significant differences in cardiac and left ventricular mass or cardiomyocyte size. Levels of serum biochemical parameters, including blood urea nitrogen, creatinine, glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, sodium, and potassium were not different among the groups. Elevations in serum levels of aldosterone in SHR rats decreased in the low sodium kimchi group. These results suggest that consuming low sodium kimchi may not adversely affect blood pressure and cardiac function even under a hypertensive condition.

• 한국임상수의학회지
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• 제29권6호
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• pp.483-487
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• 2012

심장에 발생하는 원발성 그리고 전이성 종양은 개에서는 흔치 않다. 우리는 본 연구에서 심장초음파적 진단을 이용하여 요크셔테리어 2마리에서 발생한 심장내 종괴를 확인하였다. 첫째 증례에서의 종괴는 상행 대동맥과 폐동맥 사이에 위치하고 있었으며, 중증도의 대동맥 역류와 좌심실의 확장을 유발하고 있었다. 이 증례의 환자등급은 ISACHC II 등급의 심부전으로 분류되었다. 환자에 대한 심장처방으로는 furosemide, enalapril, pimobendan 그리고 경구적인 화학요법으로는 lomustine가 처방되었다. 둘째 증례에서의 종괴는 좌심방의 2/3를 차지하고 있었으며, 좌심방의 확연한 확장과 심각한 이첨판 역류 (~5 m/s) 를 유발하고 있었으나, 환자의 심부전 등급은 ISACHC Ib 등급으로 심각한 울혈성 심부전은 나타나지 않았다. 종괴의 성상은 cardiac myxoma로 추정되었으나, 조직생검검사는 보호자의 거절로 인하여 수행되지 않았다. 환자에 대한 심장처방으로는 ramipril, clopidogrel 그리고 기관지 확장제는 aminophylline이 처방되었다. 본 증례의 두 환자들은 여전히 생존해 있으며, 정기적인 검진을 받고 있다.

• Journal of Chest Surgery
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• 제35권10호
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• pp.750-754
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• 2002

원발성 심장 종양은 드물며 이들 중 20~25%에서 악성 종양이다. 더욱이 심장에서의 원발성 악성 간엽세포종은 극히 드문데, 최근 저자 등은 2례의 심장 악성 간엽세포종을 경험하였다. 첫 번째 예는 승모판 폐쇄부전증을 보인 61세의 여자환자로 승모판을 막고있는 좌심방의 후측벽에서 생긴 악성 간엽세포종이었다. 2.7$\times$3.7cm크기의 종괴는 승모판의 후내측 교련과 판륜까지 자라고 있었다. 좌심방의 벽측은 남긴채 종괴는 부분 절제하였다. 환자는 항암치료를 받고 30일 후에 별문제 없이 퇴원하였으며, 19개월 동안 외래 추적관찰 중이다. 두 번째 예는 좌측 하폐정맥에서 기원한 4$\times$5cm기의 약하고 연노란색의 다엽성의 종괴였다. 다른 작은 종양결절들이 좌심방의 벽과 승모판 후엽에서 발견되었다. 수술은 종양의 부분절제와 승모판막치환술을 시행하였다.

• Journal of Chest Surgery
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• 제28권5호
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• pp.491-494
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• 1995

A fibroma arising in the right ventricle outflow tract of a 14 month-old infant was successfully removed. The patient was first seen because of shortness of breath and tachycardia. Pertinent clinical and laboratory findings included a grade II/VI systolic murmur, blood pressure of 120/60 mmHg, slight cardiomegaly on chest X-ray, a mass obstructing the outflow tract of the right ventricle on echocardiography and magnetic resonance imaging. On october 30,1992, under cardiopulmonary bypass, a 4cm x 3cm x 3cm tumor was resected from the right ventricular outflow tract, together with a portion of the ventricular wall. Histologically, it was diagnosis as a fibroma. The patient was sent home on the 6th postoperative day following an uneventful recovery form the operation. Although cardiac fibroma is the second most common cardiac tumor in infancy and childhood, it is usually found in the left ventricle and one arising in the right ventricle is considered rare. Although it is a benign tumor, it could produce a severe cardiac dysfunction and even sudden death, depending on its size and location. With the advance in diagnostic techniques and operative management, there is a renewed interest in the early detection and operative removal of these tumors. The case herein presented is the first such case successfully managed and reported in the Korean literature.

• Advances in pediatric surgery
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• 제15권1호
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• pp.68-72
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• 2009

Neuroblastoma is the most common extracranial solid tumor in children, and accompanies various clinical symptoms including hypertension. Hypertension is associated with catecholamines secreted from the tumor, and is usually not severe. We report one case of malignant hypertension with cardiac failure in a patient with adrenal neuroblastoma, successfully treated with adrenalectomy. A 3 year-old boy complained of protrusion of the chest wall. Physical examination revealed severe hypertension with cardiac failure. The levels of metabolites of catecholamine were increased in blood (norepinephrine >2000 pg/mL) and urine (norepinephrine 1350.5 ug/day). Abdominal CT showed a 7 cm-sized solid mass arising from the right adrenal gland. After stabilizing the hemodynamics with oral phenoxybenzamine, right adrenalectomy was performed. Pathological diagnosis was a ganglioneuroblastoma. The hypertension and cardiac failure were resolved after tumor removal.

• Journal of Chest Surgery
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• 제24권7호
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• pp.701-711
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• 1991

We experienced 6 cases of primary cardiac tumor, all received operation for removal of tumor. Mean age was 43.8 years-old ranging from 17 years-old to 66 years-old. Five cases were female, one case was male. Five cases were benign, myxoma, all located within left atrium. One case was malignant, angiosarcoma within right atrium. All patient showed cardiac manifestations. One case was in NYHA functional class II, two were in III, three were in IV. Four patients showed constitutional symptoms, but no one showed evidence of embolic phenomenon. All case of myxoma showed cardiomegaly except one malignancy. Only one case was regular sinus rhythm, three were sinus tachycardia 8z two were atrial fibrillation. The most common site of tumor origin was fossa ovalis limbus[four of all]. Two of five myxomas received emergency operation, one patient died postoperatively. Lived four patients showed no evidence of recurrence[mean follow-up, 3,5 years], but one patient has Grade II /IV mitral regurgitation & in OPD follow-up now, One malignant case, 17 years-old cerebral palsy female, was angiosarcoma occupied most of right atrial chamber originated from anterior wall of right atrium, received emergency operation which was removal of mass & reconstruction of right atrium with artificial pericardial patch. This patient died on postoperative 36th day due to persistent LCOS[low cardiac output syndrome] with combined sepsis.

• Journal of Chest Surgery
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• 제18권4호
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• pp.667-672
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• 1985

Primary cardiac tumors are uncommon in all age group. In contrast, tumors metastatic to the heart are significantly more common. On rare occasions, tumor may extend into the heart chamber via inferior vena cava from other parts of the body, such as liver, kidney, and uterus cava. With recent advancement in diagnostic imaging modalities and surgical techniques, cardiac tumors are now potentially curably form of heart disease. The most important factor in diagnosing the tumor is a high index of clinical suspicion. Six patients underwent surgical removal of intracardiac tumor during a 5-year period. The mean age of the 4 women and two men was 40 years [range 23 to 60]. All patients were operated on in the last five years of the studied period. All patients had symptoms varying in duration from 1 month to 4 years [average 13 months]. 2-Dimensional echocardiography contributed most to preoperative diagnosis, confirming presence of an intracardiac tumor in all examined patients. Of the six intracardiac tumor, 5 were myxomas [4 left atrial and 1 right ventricular] and one right atrial metastasis from hepatocellular carcinoma of the liver. In all cases, tumor masses were successfully excised. One patient expired after the operation on account of low cardiac out-put syndrome. Remained one patient among six, tumor mass extended into RA and RV with a stalk via IVC. On later follow-up study showed cold area on liver scan [hepatocellular ca.], so she was transferred to internal medicine, department for chemotherapy. Follow up results showed no signs of tumor recurrence in 4 myxoma cases.