• Korean Circulation Journal
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• v.52 no.4
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• pp.251-264
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• 2022

Heart failure with preserved ejection fraction (HFpEF) accounts for approximately half of all heart failure (HF) cases. The prevalence of HFpEF is increasing due to an aging population with hypertension, diabetes mellitus, and obesity. HFpEF remains a challenging clinical entity due to a lack of effective treatment options. Traditional HF medications have not been shown to reduce mortality of patients with HFpEF, and an implantable cardioverter-defibrillator is not indicated due to normal ejection fraction. Sudden death is the most common mode of death in patients with HFpEF; however, the underlying mechanisms of sudden death are not fully elucidated. Although ventricular arrhythmias are responsible for the majority of sudden deaths in general, their contribution to sudden deaths in HFpEF patients is likely less significant. The mechanisms of ventricular arrhythmias in HFpEF are 1) reduced conduction velocity due to ventricular hypertrophy, 2) delayed repolarization due to potassium current down-regulation, 3) calcium leakage due to altered excitation-contraction coupling, and 4) increased ventricular fibrosis caused by systemic inflammation. Hypertension and subsequent ventricular hypertrophy reduce the conduction velocity in HFpEF hearts via heterogeneous distribution of connexin 43. Delayed repolarization caused by potassium current down-regulation in HFpEF hearts provides a window for early afterdepolarization to trigger ventricular arrhythmias. Altered excitation-contraction coupling in HFpEF can cause calcium to leak and trigger delayed afterdepolarization. Increased systemic inflammation and subsequent ventricular fibrosis provide substrates for re-entry. Further research is warranted to investigate the detailed mechanisms of ventricular arrhythmias in HFpEF.

• Proceedings of the KAIS Fall Conference
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• 2011.12a
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• pp.326-329
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• 2011

Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant micro-organisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.182-185
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• 2019

Aortoesophageal fistula (AEF) is a rare and potentially fatal disease that causes massive gastrointestinal bleeding. Therefore, early diagnosis and treatment are essential to prevent mortality. Controlling the massive bleeding is the most important aspect of treating AEF. The traditional surgical treatment was emergent thoracotomy, but intraoperative or perioperative mortality was high. We report a case of a patient presenting with hematemesis who was successfully treated by a staged treatment, in which bridging thoracic endovascular aortic repair was followed by delayed surgical repair of the esophagus and aorta.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.577-581
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• 2010

Descending necrotizing mediastinitis (DNM) is a complication of odontogenic or oropharyngeal infections that can spread to the mediastinum. Such infections is serious, leading to sepsis and frequently to death. Even in this era of antibiotics, the mortality rate associated with DNM is approximately 40%. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. Delayed diagnosis is the principal reason for the high mortality in DNM. Therefore, descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. We experienced a case of odontogenic infection followed by acute mediastinitis, so present now with the review of literatures.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.126-130
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• 2010

Background: The esophageal perforation is related to high morbidity and mortality rates if the diagnosis and treatment are delayed. The aim of this study is to evaluate the affecting factors on outcome and prognosis of the patients who suffer from esophageal perforation. Material and Methods: Twenty-six patients were treated with esophageal perforation in our institute from Jan. 1992 to Feb. 2010. We retrospectively reviewed the results of treatment for esophageal perforation to understand the risk factors affecting survival in patients. Results: The subjects are 26 patients suffered with esophageal perforation and the mean age is $52{\pm}17.8$ years old. 16 esophageal perforations were caused spontaneously, 25 cases were treated surgically. The mortality rate is higher in the cases o pre-operative mediastinitis. Conclusion: The shortness time interval until the beginning of treatment should be achieved to reduce the incidence of fatal post-treatment morbidity and mortality.

• Proceedings of the Korea Society of Environmental Biology Conference
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• 2003.11a
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• pp.12-15
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• 2003

The effects of the non-steroidal ecdysteroid agonist tebufenozide on larvae of C. faviplumus and C. riparius were tested in the laboratory. In the most treatments it reached a statistically significant difference from the control condition. As the concentration of tebufenozide was increased, a relatively larger proportion of the observed mortality was associated with the metamorphosis and molting process. Also, the larval mortality of the first larvae was higher than the fourth-instar larvae in C. riparius. In terms of development, the effects of tebufenozide were delayed growth stage in relatively lower concentration such as 10 $\mu\textrm{g}$/L treatments. Based on the mortality, the susceptibility followed the first-instar C. riparius > the fourth-instar C. flaviplumus > the fourth-instal C. riparius. The morphological effects showed that the first and second segments of body of exposed larvae with tebufenozide expanded slowly and not made a complete cephalothorax of pupae during long times or days. And the head capsule slipped down and forward, revealing a fragile and non-pigmented, unsclerotized new head capsule. There was obvious significant difference in the male/female ratio in contaminated fourth larvae of C. riparius. Also, due to the different emergence periods of male/female in low insecticide concentrations, mating chances or opportunities of insects should be decreased. Accordingly, ecological strategies for keeping of sustainable populations should be disrupted.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.418-423
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• 1992

Tracheo-innominate artery fistula[TIF] is the uncommon delayed fatal complication of tracheostomy. The mortality rate of the lesion, if not treated surgically, approaches 100%. A 64-year-old man presenting with a TIF after tracheostomy was treated by lateral repair and muscle interposition between the innominate artery and trachea. Preoperatively, bleeding was controlled by gauze packing around the tude under manual compression and hyperinflation of the balloon cuff of the tracheostomy tube. No abnormality was found by angiographic evaluation. The patient failed to regain consciousness and died 4 days later from sepsis.

• Journal of Trauma and Injury
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• v.25 no.3
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• pp.94-96
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• 2012

Duodenal injuries following a blunt or penetrating trauma are uncommon and account for just 3% to 5% of all abdominal injuries. About 22% of all duodenal injuries are caused by blunt trauma. An overlooked injury or delayed diagnosis of duodenal injury may lead to increased mortality and morbidity. We report two cases of a duodenal injury following blunt abdominal trauma.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1052-1055
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• 1994

Congenital esophageal atresia without tracheoesophageal fistula which called isolated esophageal atresia is a very rare entity and the neonate classified as category C by Waterston`s classification has high mortality rate. We experienced a case of isolated esophageal atresia. This patient was a male with 1,750gm in body weight and had been suffered from bilateral pneumonia. The patient was managed with staged operation. Feeding gastrostomy was made as the first intervention and delayed primary anastomosis was performed 3 months later. The postoperative course was uneventful and he was discharged on the 22nd postoperative day.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.488-496
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• 1988

Thirty-seven patients of aortic aneurysm underwent operations during January 1984 December 1987 at our hospital. Twenty-six patients had aneurysms involving ascending aorta, three patients had aneurysms involving both ascending aorta and abdominal aorta. and eleven patients had aneurysms involving descending thoracic or abdominal aorta. Among the patients who had aneurysms involving ascending aorta, annuloaortic ectasia with aortic regurgitation were thirteen and all of these underwent ascending aorta graft replacement + AVR with composite graft. The patients who had aortic regurgitation due to ascending aortic dissection were three and all of these underwent intraluminal ringed graft insertion at ascending aorta + aortic valve resuspension. Intraluminal ringed graft insertion was safe, simple, and fast method in the operation for aortic aneurysm. Eleven patients were underwent this operation and the results were good. Major causes of death of the patients who underwent aortic aneurysm operation are underlying cardiovascular diseases or delayed rupture of the aneurysm or complications related newly appeared aneurysm. Among our patients, dissection progressions were appeared in two but neither severe nor complicated. And no patient died from delayed rupture of aneurysm or complications related newly appeared aneurysm. All patients were followed up via OPD and were controlled hypertension or heart failure if present. Operative mortality is 18.9\ulcornera in all, 23% in patients who had aneurysms involving ascending aorta and 7.6` who had aneurysms involving descending thoracic or abdominal aorta. Comparing with other reports, our operative mortality is still high but improved steadily. So we recommend aggressive surgical management of the aortic aneurysm.