• Journal of Chest Surgery
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• v.53 no.2
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• pp.79-81
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• 2020

Treatment options for children with end-stage heart failure are limited. We report the first case of a successful pediatric heart transplantation bridged with a durable left ventricular assist device in Korea. A 10-month-old female infant with dilated cardiomyopathy and left ventricular non-compaction was listed for heart transplantation. During the waiting period, the patient's status deteriorated. Therefore, we decided to provide support with a durable left ventricular assist device as a bridge to transplantation. The patient was successfully bridged to heart transplantation with effective support and without any major adverse events.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.61-65
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• 2019

Hamartomas are non-neoplastic malformations or congenital errors of tissue development. Hamartoma is composed by an excessive growth of mature tissue present in wrong proportions and abnormal arrangements. The lesion usually presents as a submucosal mass with ill-defined margins. Hamartoma occurs in all areas of the body, especially in the liver, spleen, kidney and lung. However, hamartoma is very rare in the head and neck. Presenting symptoms of hamartoma are typically vague and nonspecific. Treatment of hamartomas consists of adequate surgical excision. We present a 59 year-old male patient who presented with submental swelling. Malignancy could not be ruled out with preoperative radiologic examination, so surgical excision was planned. The mass was excised with transcervical approach. Histopathologic examination has confirmed the mass as a mucinous gland adenomatoid hamartoma.

• Journal of Ginseng Research
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• v.33 no.4
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• pp.283-293
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• 2009

Ginsenosides, one of the most well-known traditional herbal medicines, are used frequently in Korea for the treatment of cardiovascular symptoms. The effects of ginseng saponin on ischemia-induced isolated rat heart were investigated through analyses of hemodynamic changes including perfusion pressure, aortic flow, coronary flow, and cardiac output. Isolated rat hearts were perfused and then subjected to 30 min of global ischemia followed by 60 min of reperfusion with modified Kreb's Henseleit solution. Myocardial contractile function was continuously recorded. Ginseng saponin administered before inducing ischemia significantly prevented decreases in perfusion pressure, aortic flow, coronary flow, and cardiac output. The ginseng saponin administered group significantly recovered all of the hemodynamic parameters, except heart rate, after ischemia-reperfusion (I/R) compared with ischemia control. The intracellular calcium ($[Ca^{2+}]_i$) content in rat neonatal cardiomyocytes was quantitatively determined. Administration of ginseng saponin significantly prevented $[Ca^{2+}]_i$ increase that had been induced by simulated I/R in vitro (p<0.01) in a dose-dependent manner, suggesting that the cardioprotection of ginseng saponin is mediated by the inhibition of $[Ca^{2+}]_i$ increase. Overall, we found that the administration of ginseng saponin has cardioprotective effects on the isolated rat heart after I/R injury. These results indicate that ginseng saponin has distinct cardioprotective effects in an I/R-induced rat heart.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.450-453
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• 2005

Broncholithiasis is uncommon in patients with silicosis. Bronchoesophageal fistula complicated by broncholithiasis is especially rare and only one case has been reported in Korea. Surgical treatment of broncholithiasis should be as conservative as possible to preserve the adequate pulmonary function. Meticulous dissection and division of the fistula with the interposition of viable tissues will prevent recurrence, We report a rare case of bronchoesophageal fistula complicated by broncholithiasis in a patient with silicosis.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.319-322
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• 2024

Venovenous extracorporeal membrane oxygenation (VV ECMO) is often used in cases of severe respiratory failure, especially in patients considered for lung transplantation. However, because many lung diseases can ultimately result in right heart failure, the treatment of secondary right heart failure can present a challenge when the patient is already under VV ECMO support. In such cases, an oxygenated-right ventricular assist device (OxyRVAD) can be used. OxyRVAD is designed to maintain anterograde blood flow and prevent right ventricular distension. Moreover, the pulmonary arterial cannula can be inserted percutaneously. We report a case in which percutaneous OxyRVAD was successfully implemented to manage right heart failure in a patient with respiratory failure who was on VV ECMO.

• 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.

• Korean Circulation Journal
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• v.52 no.3
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• pp.173-197
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• 2022

Treatment options for patients with heart failure (HF) with reduced ejection fraction (HFrEF) have expanded considerably over the past few decades. Whereas neurohormonal modulation remains central to the management of patients with HFrEF, other pathways have been targeted with drugs that have novel mechanisms of action. The angiotensin receptor-neprilysin inhibitors (ARNIs) which enhance levels of compensatory molecules such as the natriuretic peptides while simultaneously providing angiotensin receptor blockade have emerged as the preferred strategy for inhibiting the renin angiotensin system. Sodium glucose cotransporter 2 (SGLT2) inhibitors which were developed as hypoglycemic agents have been shown to improve outcomes in patients with HF regardless of their diabetic status. These agents along with beta blockers and mineralocorticoid receptor antagonists are the core medical therapies for patients with HFrEF. Additional approaches using ivabradine to slow heart rate in patients with sinus rhythm, the hydralazine/isosorbide dinitrate combination to unload the heart, digoxin to provide inotropic support and vericiguat to augment cyclic guanosine monophosphate production have been shown in well-designed trials to have beneficial effects in the HFrEF population and are used as adjuncts to the core therapies in selected patients. This review provides an overview of the medical management of patients with HFrEF with focus on the major developments that have taken place in the field. It offers prospective of how these drugs should be employed in clinical practice and also a glimpse into some strategies that may prove to be useful in the future.

• The Journal of Korean Obstetrics and Gynecology
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• v.28 no.2
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• pp.193-203
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• 2015

Objectives : The purpose of this study is to evaluate the clinical effects of ascending kidney water and descending heart fire pharmacopuncture treatment for hot flush and sweating. Methods : Ascending kidney water and descending heart fire pharmacopuncture is achieved by injecting pharmacopuncture on a specific acupoint to change from the state of water-fire disharmony to harmonious state. Hwangryunhaedok-tang (黃連解毒湯) pharmacopuncture is injected on both side Gyeonjeong (GB ₂₁ ), Pungji (GB ₂₀ ). Total 0.4 cc was injected by 0.1 cc each point. BUM (Bear’s gall bladder, ox bezoar and musk) pharmacopuncture is injected on both side Jeonjung (CV ₁₇ ), Jungwan (CV ₁₂ ), Gihae (CV ₆ ). Total 0.15 cc was injected by 0.05 cc each point. Treatment was done daily. The method of evaluation are Hot Flush Score (HFS), VAS and sweating areas. Results : In case 1, after treatment hot flush score was reduced from 24 to 4 points. VAS scale was reduced from 7 to 2. It took about two weeks for the symptoms to decrease by half. Associated symptoms almost did not stay at discharge. In case 2, after treatment hot flush score was reduced from 28 to 2 points. VAS scale was reduced from 10 to 3. And emotional symptoms were reduced about 70%. In case 3, after treatment hot flush score was reduced from 8 to 1 points. VAS scale was reduced from 6 to 1. And headache and chest discomfort symptoms have disappeared. Conclusions : Ascending kidney water and descending heart fire pharmacopuncture treatment is effective for improve ascending kidney water and descending heart fire energy. Therefore, it will be used to alleviate hot flush and sweating.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.11
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• pp.357-360
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• 1997

For medical students and doctors, knowledge of the 3-dimensional (3D) structure of the heart is very important in diagnosis and treatment of the heart diseases. 2-dimensional (2D) tools (e.g. anatomy book) or classical 3D tools (e.g. plastic model) are not sufficient or understanding the complex structures of the heart. Moreover, it is not always guaranteed to dissect the heart of cadaver when it is necessary. To overcome this problem, virtual dissection systems of the heart have been developed. But these systems are not satisfactory since they are made of radiographs; they are not true 3D images; they can not be used to dissect freely; or they can only be operated on the workstation. It is also necessary to make the dissection systems incorporating the various races and tribes because of the organ's difference according to race and tribe. This study was intended to make the 3D image of the heart from a Korean cadaver, and to establish a virtual dissection system of the heart with a personal computer. The procedures or manufacturing this system were as follows. 1. The heart from a Korean adult cadaver was embedded with gelatin solution, and serially cross-sectioned at 1mm-thickness on a meat slicer. Pictures or 153 cross-sectioned specimens were inputted into the computer using a digital camera ($756{\times}504$ resolution, true color). 2. The alignment system was established by means of the language of IDL, and applied to align 2D images of the heart. In each of 2D images, closed curves lining clean and dirty blood pathways were drawn manually on the CorelDRAW program. 3. Using the language of IDL, the 3D image and the virtual dissection system of the heart were constructed. The virtual dissection system of the heart allowed or ree rotation, any-directional sectioning, and selected visualization of the heart's structure. This system is expected to become more advanced, and to be used widely through Internet or CD-title as an educational tool for medical students and doctors.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.240-246
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• 1979

A 15-year-old boy having a small VSD was readmitted with clinical manifestations of acute endocarditis and aortic regurgitation one month after open heart surgery. In spite of vigorous treatment with broad-spectrum antibiotics, high fever persisted. Pseudomonas aeruginosa was isolated just one time among several blood cultures. Progressive pulmonary infarction due to embolization. Progressive congestive heart failure and D.I.C. caused patient`s death. Aspergillus was found in autopsy specimen.