• Journal of Chest Surgery
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• 제27권8호
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• pp.700-704
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• 1994

Congenital coronary arteriovenous fistula is relatively rare congenital heart disease which has formation of fistula between coronary artery and cardiac ventricle, atrium, or pulmonary artery, but that can be repaired with simple surgical procedure. We experienced three cases of congenital coronary arteriovenous fistula, which were repaired surgically under cardiopulmonary bypass, so we report these cases with review of the literatures.

• 대한지역사회영양학회지
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• 제10권6호
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• pp.963-970
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• 2005

Recently elevated plasma homocysteine concentration is considered an independent risk factor for atherosclerosis and thrombosis with coronary artery disease. Folate and vitamin $B_{12}$ are cofactors and closely related with metabolism of homocysteine. The purpose of this study is to evaluate the correlation between homocysteine and folate and vitamin $B_{12}$ in patients with ischemic heart disease. Twenty-six patients, in whom coronary angiographic finding revealed more than $50\%$ of stenosis at least in one coronary vessel were enrolled as the patient group, and thirty subjects, in whom angiographic finding revealed in not significant stenosis, but complained of chest pain, were selected as the control group. Fasting venous blood was obtained and measured the concentration of plasma total homocysteine, folate and vitamin $B_{12}$ by high performance liquid chromatography and fluorescence detection method. We examined the correlation between homocysteine and folate and/or vitamin $B_{12}$ in the control group and the patient group, respectively. Compared with the control group, the patient group had relatively higher plasma total homocysteine concentration ($10.7\pm4.2\;vs\;9.6\pm3.5$ umol/L), but showed no significant difference. Folate and vitamin $B_{12}$ concentration are low in the patient group, but showed no significant difference between patient and control group. Plasma total homocysteine concentration showed negative correlation with folate and vitamin $B_{12}$ in both the control group and the patient group, and showed significantly negative correlation in patient group {r = -0.550 (p < 0.01) vs r = -0.609 (p < 0.01)}. We knew that the plasma total homocysteine concentration were relatively elevated in patient group compared with the control group. Because plasma total homocysteine concentrations are closely negative correlated with folate and vitamin $B_{12}$ in the patient group, folate and vitamin $B_{12}$ supplement can lower the mortality and morbidity of ischemic heart disease. (Korean J Community Nutrition 10(6) : $963\∼970$, 2005)

• 대한핵의학회지
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• 제27권1호
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• pp.65-70
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• 1993

Among 64 patients with acute myocardial infarction who underwent coronary angiogrphy, 7 patients (10.9%) showed normal coronary artery. Six patients were men and 1 patient was female. The mean age of patients were $31.1{\pm}3.9$ years. Among the risk factors of coronary heart disease, smoking was most probable factor in patients with acute myocardial infarction with normal coronary angiography. $^{99m}Tc$-MIBI heart SPECT performed 5 of 7 patients and showed that it could be used in diagnosis, localization, extent of infarct area in patients with acute myocardial infarction with normal coronary angiograpy. But follow up $^{99m}Tc$-MIBI heart SPECT study will be needed to define the ability of myocardial viability in this patients.

• Journal of Chest Surgery
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• 제23권1호
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• pp.162-168
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• 1990

Unroofed coronary sinus syndrome is an uncommon anomaly which is caused by incomplete formation of the left atriovenous fold and it is usually associated with persistent left superior vena cava. It may be diagnosed by cardiac catheterization and cineangiography but, if it is not diagnosed, it can bring out significant complications due to right to left shunt, such as brain abscess, cerebral embolism, transient ischemic attack, arterial desaturation and there will reduced patient`s life expectancy. Therefore corrective operation was needed. A case of unroofed coronary sinus syndrome which combines with valvular heart disease was experienced at the department of thoracic & cardiovascular surgery of Kosin medical college. The patient was 49 years old female and she complained dyspnea on exertion for 2 yrs. Cardiac catheterization with cineangiography and both superior venacavogram were performed for diagnosis and she was diagnosed as unroofed coronary sinus syndrome combined with mitral and tricuspid regurgitation. Surgical correction was accomplished by reroofing of coronary sinus with pericardial patch, closure of atrial septal defect and annuloplasty of both atrioventricular valves. Postoperative results were satisfactory and course of recovery was uneventful. We report a case of unroofed coronary sinus syndrome with review.

• Integrative Medicine Research
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• 제3권4호
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• pp.204-210
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• 2014

The aim of this review was to understand the effects of ${\beta}$-adrenergic stimulation on oxidative stress, structural remodeling, and functional alterations in the heart and cerebral artery. Diverse stimuli activate the sympathetic nervous system, leading to increased levels of catecholamines. Long-term overstimulation of the ${\beta}$-adrenergic receptor (${\beta}AR$) in response to catecholamines causes cardiovascular diseases, including cardiac hypertrophy, stroke, coronary artery disease, and heartfailure. Although catecholamines have identical sites of action in the heart and cerebral artery, the structural and functional modifications differentially activate intracellular signaling cascades. ${\beta}AR$-stimulation can increase oxidative stress in the heart and cerebral artery, but has also been shown to induce different cytoskeletal and functional modifications by modulating various components of the ${\beta}AR$ signal transduction pathways. Stimulation of ${\beta}AR$ leads to cardiac dysfunction due to an overload of intracellular $Ca^{2+}$ in cardiomyocytes. However, this stimulation induces vascular dysfunction through disruption of actin cytoskeleton in vascular smooth muscle cells. Many studies have shown that excessive concentrations of catecholamines during stressful conditions can produce coronary spasms or arrhythmias by inducing $Ca^{2+}$-handling abnormalities and impairing energy production in mitochondria, In this article, we highlight the different fates caused by excessive oxidative stress and disruptions in the cytoskeletal proteome network in the heart and the cerebral artery in responsed to prolonged ${\beta}AR$-stimulation.

• 대한의생명과학회지
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• 제19권3호
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• pp.254-260
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• 2013

The purpose of this study was to survey the effects of Karvonen exercise prescription in coronary artery disease patients reaching age-predicted maximal heart rates with the exercise stress test on hemodynamic responses and cardiorespiratory fitness. The subject group was comprised of acute coronary syndrome (ACS) patients, who were divided into the maximal heart rate (MHR) group that included those who completed the test with their heart rates reaching the number of 220-age and the maximal dyspnea (MD) group that included those who could not continue the test due to respiratory difficulty and were asked to stop the test. Both groups had the exercise stress test before and after the experiment. In the exercise stress test before the experiment, the exercise prescription intensity of Karvonen was set at the target heart rates of 50~85% with a six-week exercise monitoring arrangement. As a result, there were no interactive effects in rest heart rate (RHR) according to time and group, but interactive effects were observed in maximal heart rate (MHR) (P=0.000). Both rest systolic blood pressure (RSBP) and rest diastolic blood pressure (RDBP) had no interactive effects according to time and group. Maximal systolic blood pressure (MSBP) showed significant interactive effects according to time and group (P=0.017). Maximal diastolic blood pressure (MDBP) showed no interactive effects according to time and group, while maximal rate pressure product (MRPP) showed significant interactive effects according to time and group (P=0.003). Maximal time (MT) had no interactive effects according to time and group. $VO_{2max}$ and maximal metabolic equivalent (MMET) showed significant interactive effects according to time and group (P=0.000, P=0.002, respectively), whereas maximal respiratory exchange ratio (MRER) and maximal rating of perceived exertion (MRPE) showed no interactive effects according to time and group. The exercise test that was discontinued as the subjects reached the predicted maximal heart rates considering age did not reach the maximal exercise intensity and accordingly showed low exercise effects when applied to Karvonen exercise prescription intensity. That is, the test should keep going by monitoring cardiac events, MRER and MRPE until the heart rates exceed the predicted MHR by up to 10~12 even after the subject reaches the predicted MHR considering age in the exercise stress test.

• Journal of Nutrition and Health
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• 제33권6호
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• pp.668-674
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• 2000

This study was to examine effects of the eight month exercise program at lactate threshold level intensity on 11 women patients of ischemic heart disease. The %body fat and systolic blood pressure were decreased and the aerobic capacioties of oxygen consumption as well as oxygen consumption at lactate threshold were improved through the exercise program arranged by this study. The lipid variables concerned with coronary heart disease were changed a little except that triglyceride was significantly decreased during the exercise program. The effects obtained from exercise program during four months lasted to the end of the exercise program. In case we control the exercise intensity according to increase of oxygen consumption at lactate threshold the exercise program conducted by this study will be effective to the treatment for ischemic heart disease patients.(Korean J Nutrition 33(6) . 668~674, 2000)

• Journal of Chest Surgery
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• 제28권11호
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• pp.994-1000
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• 1995

Thirty patients with ischemic heart disease underwent coronary artery bypass grafting [CABG from 1985 through 1994. There were 16 males and 14 females whose age ranged from 41 to 72 years old. Preoperative diagnoses were unstable angina in 13 of patients, stable angina in 8, postmyocardial infarction state in 7, and state of failed percutaneous transluminal coronary angioplasty [ PTCA in 2. The patterns of disease were single vessel involvement [ 17cases , double vessel involvement [ 7 cases , triple vessel involvement [ 3 cases , Lt main lesion including Lt. ostial lesion [ 3 cases . Saphenous vein grafts were used in 27/30 patients [ 90% , and internal mammary artery grafts were used in 6/30 patients [ 20% . The hospital mortality was 13.3% and all survivors were asymptomatic and improved over their preoperative status.

• Nuclear Medicine and Molecular Imaging
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• 제42권5호
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• pp.362-368
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• 2008

목적: T1-201 심근 SPECT에서 심장 대 폐 섭취비의 증가(LHR)는 심근관류스캔의 고위험소견으로 알려져 있으나, 약물부하 Tc-99m tetrofosmin 게이트 심근 SPECT에서 측정되는 LHR도 같은 역할을 하는지에 대하여는 의문이 있다. 이에 저자는 약물부하 Tc-99m tetrofosmin 게이트 심근 SPECT에서 측정된 LHR과 관상동맥조영술 및 게이트 심근관류 SPECT소견을 비교하여 이의 유용성을 알아보고자 하였다. 대상 및 방법: 관상동맥질환이 의심되어 아데노신 부하 Tc-99m tetrofosmin 게이트 심근 SPECT를 시행한 환자 중 관상동맥조영술을 한 달 이내에 시행한 환자 157명을 대상으로 하였다. 게이트 SPECT는 먼저 휴식기 영상을 얻고, 3-4시간 후 아데노신 부하 영상을 얻었다. 총 157명의 대상환자에서 측정된 LHR과 관상동맥조영슬과 게이트 심근 관류 SPECT 결과를 비교하였다. 결과: 정상 대조군 50명에서 얻은 LHR은 $0.33{\pm}0.04$이었으며, 성별의 차이는 없었다. LHR이 0.41(평균+2표준편차)을 초과한 경우 LHR이 증가된 것으로 간주하였다. 정상관상동맥을 보인 53명 중 2명 (3.8%), 단일혈관질환 44명에서는 0명, 두혈관질환 27명 중 2명(7.4%), 세혈관질환 33명 중 8명(24.2%)에서 증가된 LHR을 보였다. LHR은 부하기 및 휴식기의 좌심실구혈률과 약한 음의 상관관계를 보였으며(r=-0.25, -0.25), 부하기 및 휴식기 관류결손의 총합과는 약한 양의 상관관계를 보였다(r=0.37, 0.36). 결론: 약물부하 후 1시간에 촬영한 Tc-99m tetrofosmin의 LHR은 세혈관질환을 가진 군과 심한 좌심실 기능부전을 가진 군, 그리고 부하기 및 휴식기 영상에서 심한 관류결손을 가진 군에서 높아서, 기존의 T1-201을 이용한 연구와 비슷하였으나, 연관성은 낮았다.

• 보험의학회지
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• 제2권1호
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• pp.17-33
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• 1985