• Title/Summary/Keyword: cardiovascular system

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Delayed Treatment of Iatrogenic Brachial Arteriovenous Fistula

  • Youn, Young-jin;Kim, Chang Wan;Park, Il Hwan;Byun, Chun Sung
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.408-410
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    • 2020
  • Iatrogenic vascular injuries may occur during venipuncture, arterial cannulation, or catheterization procedures. Brachial arteriovenous fistula (AVF) resulting from antecubital vascular access is rare and develops slowly. We report the case of an 18-year-old man who had developed iatrogenic brachial AVF. He had a history of several venipunctures in the left arm at the age of 10 months. Doppler ultrasonography and computed tomographic angiography were used to establish a diagnosis of brachial AVF, and surgical correction of the AVF was performed. As our case indicates, delayed surgery can be considered as a treatment option and may be associated with a decreased risk of vascular complications in the management of iatrogenic brachial AVF in infants.

A 69-year-old Woman with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery: Surgical Repair Using a Trap-door Flap

  • Lim, Ju-Yong;Chung, Cheol-Hyun;Ma, Dae-Sung;Lee, Seung-Hyun
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.358-360
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    • 2011
  • We present a patient with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), which was diagnosed and corrected in her 60 s. The patient is the oldest documented survivor of ALCAPA who underwent a surgical repair. ALCAPA should be corrected surgically to restore the dual coronary system at any age and this case shows that the surgical procedure may be performed safely even in an elderly patient.

Successful Heart Transplantation Despite Rhesus Blood Type Mismatch: A Case Report

  • Ji Hong Kim;Yu-Rim Shin
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.217-219
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    • 2024
  • Matching for the rhesus (Rh) blood group is currently not taken into account in the organ allocation system. However, in Rh-mismatched transplantation, the primary concern is the potential for RhD-negative recipients to develop sensitization and produce anti-D antibodies if they receive a transfusion of RhD-positive blood. It is estimated that over 80% of RhD-negative recipients may experience Rh allosensitization when exposed to RhD-positive blood, although this occurrence is less common in recipients of solid organs. In theory, RhD-negative recipients who receive organs from RhD-positive donors are at risk of alloimmunization and the production of anti-D antibodies, which could complicate future blood product transfusions. However, our understanding of the impact of donor-recipient Rh mismatch on transplant outcomes, particularly in heart transplantation, is limited. We report a case of successful Rh-mismatched heart transplantation, which was effectively managed through the use of preoperative RhD immunoglobulin and plasmapheresis.

The Critical Roles of Zinc: Beyond Impact on Myocardial Signaling

  • Lee, Sung Ryul;Noh, Su Jin;Pronto, Julius Ryan;Jeong, Yu Jeong;Kim, Hyoung Kyu;Song, In Sung;Xu, Zhelong;Kwon, Hyog Young;Kang, Se Chan;Sohn, Eun-Hwa;Ko, Kyung Soo;Rhee, Byoung Doo;Kim, Nari;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.5
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    • pp.389-399
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    • 2015
  • Zinc has been considered as a vital constituent of proteins, including enzymes. Mobile reactive zinc ($Zn^{2+}$) is the key form of zinc involved in signal transductions, which are mainly driven by its binding to proteins or the release of zinc from proteins, possibly via a redox switch. There has been growing evidence of zinc's critical role in cell signaling, due to its flexible coordination geometry and rapid shifts in protein conformation to perform biological reactions. The importance and complexity of $Zn^{2+}$ activity has been presumed to parallel the degree of calcium's participation in cellular processes. Whole body and cellular $Zn^{2+}$ levels are largely regulated by metallothioneins (MTs), $Zn^{2+}$ importers (ZIPs), and $Zn^{2+}$ transporters (ZnTs). Numerous proteins involved in signaling pathways, mitochondrial metabolism, and ion channels that play a pivotal role in controlling cardiac contractility are common targets of $Zn^{2+}$. However, these regulatory actions of $Zn^{2+}$ are not limited to the function of the heart, but also extend to numerous other organ systems, such as the central nervous system, immune system, cardiovascular tissue, and secretory glands, such as the pancreas, prostate, and mammary glands. In this review, the regulation of cellular $Zn^{2+}$ levels, $Zn^{2+}$-mediated signal transduction, impacts of $Zn^{2+}$ on ion channels and mitochondrial metabolism, and finally, the implications of $Zn^{2+}$ in health and disease development were outlined to help widen the current understanding of the versatile and complex roles of $Zn^{2+}$.

General Pharmacology of Bamboo Salt (죽염의 일반약리작용)

  • 유태무;김순선;노용남;이숙영;김옥희;류항묵;양지선
    • Biomolecules & Therapeutics
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    • v.8 no.1
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    • pp.93-98
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    • 2000
  • This study has been carried out to investigate general pharmacological action of bamboo salt (jukyom) in terms of effects on central nervous system and cardiovascular system in experimental animals. After bamboo salt, crude salt or reagent-grade NaCl were orally administered into male ICR mice with dose of 2.0 g/kg, general behavioural syndromes such as body weight and locomotor activity, spontaneous motor activity, pento-barbital-induced sleeping time, muscle incoordination, electroshock-induced convulsion, body temperature and writhing response caused by 0.6% acetic acid solution were observed. Bamboo salt had no influences in these indices for examinition of effect on central nervous system. Additionally, conscious male Sprague Dawley rats fastened overnight won ere treated with bamboo salt, crude salt or reagent-grade NaCl (2.0 g/kg, p.o.) to examine the effect of these salts cardiovascular system. Systolic, median and diastolic food pressure and heart rate were dertemined using tail cuff indirect method. Treatment with Hydralazine (50 mg/kg, p.o) as a positive control produced the decreases in systolic, median and diastolic blood treasure and an increase in heart rate. whereas no changes were observed in bamboo salt, crude salt and reagent-grade NaCl treated groups. These results strongly suggest that bamboo salt may have no effects on general pharmacology of central nervous systems and cardio-vascular systems.

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A Case Report of Multiple System Atrophy in a Cerebellar Ataxia Patient Suffering from Gait Disturbance Treated with Korean Medicine (보행장애를 주소로 하는 소뇌형 다계통 위축증 환자의 한방 치료 1례)

  • Woo, Seong-jin;Baek, Kyung-min;Jang, Woo-seok
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.806-814
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    • 2016
  • Objective: To describe the effect of Korean medicine on gait disturbance in a patient with multiple system atrophy and cerebellar ataxia. Methods: We observed a 75-year-old female patient who had multiple system atrophy and cerebellar ataxia. The patient was treated with Korean medicine, including acupuncture, moxibustion, and herbal medicine (Yukmijihwang-tang-gamibang and Boyanghwano-tang-gamibang) for 38 days. We evaluated the patient with the Korean version of the Berg Balance Scale (K-BBS), the Unified Multiple System Atrophy Rating Scale (UMSARS), and the Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient’s symptoms were improved. The K-BBS score increased from 9 to 19, while the UMSARS score decreased from 16 to 12 in Part I, from 15 to 7 in part Ⅱ, and from 4 to 3 in part Ⅳ. The NRS-11 score of gait disturbance decreased from 10 to 5. Conclusions: Korean medicine may be an effective treatment for gait disturbance in multiple system atrophy with cerebellar ataxia.

A Case of Self-prescribed Licorice-induced Hypokalemic Paralysis (자가 처방 감초 다량 복용 후 발생한 저칼륨성 하지마비 1례)

  • Kwon, Seung-Won;Jeong, Hwan-Yong;Yoon, Seung-Kyou;Seo, Yu-Ri;Park, Joon-Young;Im, Jin-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Korean Medicine
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    • v.32 no.5
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    • pp.134-138
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    • 2011
  • Glycyrrhetinic acid, which is a component of licorice, can cause hypermineralocorticoidism through the inhibition of $11{\beta}$-hydroxysteroid dehydrogenase. So, a high dose intake of licorice can lead to hypermineralocorticoidism with potassium loss and depression of the renin-angiotensin-aldosterone system. We report a 73-year-old man with muscle weakness of proximal lower limbs with hypokalemia (Serum $K^+$: 1.4 mEq/L) due to taking self-prescribed licorice without OMD's diagnosis. He boiled 60~100g licorice / day in water and drank it intermittently for 1 month due to arthralgia and swelling of both his knees. Patient's serum renin activity and aldosterone level were far beyond the normal range. He also had metabolic alkalosis with pH 7.552. After quitting the licorice, hypokalemia and muscle weakness of proximal lower limbs gradually improved within 1week.

The In-hospital Clinical Outcomes of Extracorporeal Life Support after Adult Cardiovascular Surgery (성인 심혈관 수술 후 시행한 체외순환보조의 조기 임상결과)

  • Yie, Kil-Soo;Na, Chan-Young;Oh, Sam-Sae;Kim, Jae-Hyun;Ryu, Se-Min;Park, Sung-Min;Cho, Seong-Joon
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.464-472
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    • 2009
  • Background: We analyzed the clinical results and the factors for survival of patients who underwent extracorporeal life support system after adult cardiovascular surgery. Material and Method: We retrospectively reviewed the medical record of 44 patients (1.6% of the total adult cardiovascular surgical cases) who underwent the use of a ventricular assisted device or extracorporeal membrane oxygenation from January 2002 to August 2008. There were 32 (72.7%) males and their mean age was 61.7$\pm$14.9(range: 20$\sim$73) years old. The mean duration of extracorporeal life support system was 5.3$\pm$3.0 (range: 1$\sim$12) days. Result: Of these 44 patients, 24 (54.5%) patients were successfully weaned from the extracorporeal device. Eighteen (40.9%) survivors were able to be discharged from the hospital. Complications were noted in 38 patients (86.4%). An emergency operation, no usage of a concomitant intraaortic balloon pump and major complications during use of the extra corporeal life support system such as bleeding, flow instability and renal failure were identified as significant risk factors for poor survival on univariated analysis. Owing to educational support and a continuous renal replacement therapy system, the clinical outcomes of these patients have improved since 2006. On multivariated analysis, renal failure and bleeding during extracorporeal life support were significant risk factors for poor survival. Conclusion: Although using. extracorporeal life support systems after adult cardiovascular surgery revealed acceptable clinical results, determining the optimal treatment strategy and further well designed larger studies are needed to improve the survival rate of patients who undergo extracorporeal life support after adult cardiovascular surgery.

Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Expert Recommendations from The Korean Society for Thoracic and Cardiovascular Surgery

  • Jeong, In Seok;Kim, Woong-Han;Baek, Jong Hyun;Choi, Chang-Hyu;Choi, Chang Woo;Chung, Euy Suk;Jang, Jae Seok;Jang, Woo Sung;Jung, Hanna;Jung, Jae-Seung;Kang, Pil Je;Kim, Dong Jung;Kim, Do Wan;Kim, Hyoung Soo;Kim, Jae Bum;Kim, Woo-Shik;Kim, Young Sam;Kwak, Jae Gun;Lee, Haeyoung;Lee, Seok In;Lim, Jae Woong;Oh, Se Jin;Oh, Tak-Hyuck;Park, Chun Soo;Ryu, Kyoung Min;Shim, Man-Shik;Son, Joohyung;Son, Kuk Hui;Song, Seunghwan;The Korean Society for Thoracic and Cardiovascular Surgery COVID-19 ECMO Task Force Team
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.2-8
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    • 2021
  • Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.

The Effect of Controlled Respiration on the Impedance Cardiography and the Second Derivative of PhotoPlethysmography (호흡 제어에 따른 임피던스 심장도와 지첨용적맥파에 관한 연구)

  • Ko, Young-Il;Park, Young-Bae;Park, Young-Jae;Lee, Hyon-Soo
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.11 no.1
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    • pp.82-104
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    • 2007
  • Purpose: We performed this study to examine the effect of controlled respiration on cardiovascular system in healthy adult subjects using impedance cardiography and photoplethysmography. Materials and Methods: This study had performed on 74 subjects, which were healthy men and women without a experience of respiration practice. Using the instruments for impedance cardiography and photoplethysmography, parameters of each subject had been measured after each controlled respirations which were natural respiration, controlled natural respiration (I:E=1.1.6), longer inspiration(I:E=3:3), and longer expiration(I:E=2:4). The measured parameters of impedance cardiography and photoplethysmography were processed statistically by one-way repeated ANOVA. Results: 1. HR and CI of impedance cardiography were decreased significantly during controlled respiration comparing with the result of basal state(the state of enough break). There was no significant difference among the results of controlled respiration. 2. PEP of impedance cardiography had no significant difference among the result of basal state and the results of controlled respiration(p=0.059). 3. VI of impedance cardiography had significant differences among the result of basal state and the results of controlled respiration, and decreased continuously through the controlled respiration. 4. b/a of photoplethysmography had no significant difference among the result of basal state and the results of controlled respiration(p=0.554). 5. c/a of photoplethysmography were decreased significantly during controlled respiration comparing with the result of basal state. There was no significant difference among the results of controlled respiration. 6. d/a of photoplethysmography had significant differences among the results of the controlled respiration decreasing continuously through the controlled respiration and had no significant difference between the result of basal state and the result of natural respiration. 7. AGI of photoplethysmography had significant differences among the result of basal state and the results of the controlled respiration increasing continuously through the controlled respiration. Conclusion: We had examined the effects of controlled respirations on cardiovascular system in multiple points of view. The effects of controlled respirations on cardiovascular system can't be explained in a simple way, as the cardiovascular system is controlled by many factors. Therefore, more physiological parameters must be measured in the future study on the effect of the controlled respiration on human cardiovascular system.

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