• Journal of Chest Surgery
• /
• v.27 no.10
• /
• pp.854-857
• /
• 1994

Hypothermia and circulatory arrest is efficatious adjunct in the surgical treatment of conventionally difficult or otherwise inoperable lesion. This technique was utilized in 5 patients, 3 with membraneous obstruction of inferior vena cava[MOVC] and 1 with giant middle cerebral artery aneurysm and 1 with renal cell carcinoma invading inferior vena cava. All membraneous obstruction of inferior vena cava patients had excellent results but the others died of operative complications. The rationale for the use of complete cardiac arrest with hypothermia is reviewed and the use of these technique in selected patients is warrented.

• Journal of Nutrition and Health
• /
• v.32 no.6
• /
• pp.681-690
• /
• 1999

The purpose of this study was to investigate whether nutrition counseling could lead to a beneficial outcomes in patients with cardiovascular disease(CVD). Fifty CVD patients(23 men and 27 women) participated in a dietary counseling program which was based on serum lipid management. Various markers of disease risk including lifestyles, anthropometric indices, eating behaviors, serum lipids, antioxidants, lipid peroxides were measured before and after the program. The program lasted 3-11 months depending on individuals. Waist/hip ratio decreased after nutrition counseling only in women. Smoking and alcohol drinking status did not change significantly after counseling. Food habit score increased significantly in both men and women(p<0.05), and patients consumed mixed cereal rice, fruits, seaweeds, legumes more frequently and snacks less frequently after nutrition counseling (p<0.05). Although intakes of energy, carbohydrate and vitamin B1 were reduced significantly after nutrition counseling, nutrient densities of calcium and iron of diets have increased significantly after nutrition counseling, and those of other micronutrients were not different Serum total cholesterol decreased significantly in men and LDL cholesterol decreased significantly in women. In women lipid peroxide level decreased and $\alpha$-tocopherol level increased significantly, while there was no significantly change in men. We conclude that well-planned nutrition counseling would reduce risks of cardiovascular disease through improving dietary behavior, lipid profile and antioxidant status.

• Journal of Chest Surgery
• /
• v.30 no.12
• /
• pp.1205-1213
• /
• 1997

This study reviewed useful aspects of the intraoperative transesophageal echocardiography among the patients in whom heart surgery were undertaken between January 1996 and July 1996 at St.Pauls hospital, Medical College of Catholic University, Seoul, Korea. During that period, 61 patients were operated on because of valvular heart disease(25 patients), coronary artery disease(22 patients), congenital heart disease(13 patients), and combined coronary artery disease and valvular heart disease(1 patient). Two patients(1 redo-VSD and 1 valvular heart diease) needed repeated aortic cross clamping and complementary procedures because of incomplete initial procedures. There was no incidence of air embolism. We could observe significant relationship of cardiac output monitoring methods either by thermodilution technique and transesophageal echocardiography by linear regression analysis(p<0.001). We tested myocardial response(percentage of systolic wall thickness, PSWT) with low dose dobutamine challenge to predict post-CABG myocardial perfusion. And the test showed statistically significant resp.onse(sensitivity 76%, specificity 94.7%, positive predictive value 95%, negative predictive value 75%). These results suggest that cardiac surgeon could draw more benefits by intraoperative transesophageal echocardiography.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.5 no.1
• /
• pp.47-64
• /
• 1998

This study was conducted to collect the baseline data of physical health status and nursing needs of the elderly for developing an educational program for nursing professionals. The data was collected from 287 people who were 65 years old or older belonging to a selected 8 out of the 39 welfare centers in Pusan during the period from February 25 to November 30, 1996. Socio-demographic characteristics, frequency of hospitalization, and the prevalence of chronic illnesses were measured to assess the physical health status of the center's elderly admitted to the hospital during the period of data collection. The 5-point Likert-type scale composed of 20 items was used. The data was analyzed with the Statistical Package for the Social Sciences Program (SPSS PC+). The results were summarized as follows : 1. The proportion of elderly subjects with chronic illnesses was 73.6%. Among 6 types of chronic illnesses, hypertension was the most prevalent(23.7%), cardiovascular disease was the second(18.1%), gastrointestinal disease the third(17.1%), musculosskeletal disease the fourth(12.9%), liver and biliary disease the fifth(12.5%), and diabetes the sixth. 2. The average score of the subjects' health status was 3.649 on the 5-point Likert scale. Among the 6 factors related to physical health, personal hygiene was the strongest factor(4.612) ; elimination was the second(4.491) ; sensation the third(4.369), outside activity the fourth(3.675), digestion the fifth(3.331), and sexual life the sixth. 3. Gender, marital status, religion, educational level, family structure, living arrangements, and perceived health status were significantly related to the elderly's physical health status. 4. Among the nursing needs of the elderly, emotional support and care was the strongest need(74.2%) ; physical therapy was the second(73.2%) ; education about diease control the third(64.8%) ; medication the fourth(63.8%) ; and the range of motion exercise the fourth(61.0%).

• Journal of Chest Surgery
• /
• v.30 no.2
• /
• pp.172-178
• /
• 1997

We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.