• Title/Summary/Keyword: pulmonary circulation

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An Anatomical Study on the Networks of Five Viscera in Yixuerumen (『의학입문(醫學入門)』 오장계(五臟系)에 대한 해부학적(解剖學的) 고증(考證))

  • Jung, Hyuk-Sang;Baik, You-Sang;Kim, Do-Hoon;Jeong, Chang-Hyun;Jang, Woo-Chang
    • Journal of Korean Medical classics
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    • v.30 no.1
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    • pp.167-184
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    • 2017
  • Objectives : The paper attempted to analyze the contents found in the networks of five viscera in Yixuerumen's Zangfutiaofen published by Li Chan in 1575, and tried to reveal the body structure dealt in the contents through anatomical verification. Methods : Books such as Huataxianshengneizhaotu, Tushupian, and Shisijingfahui were used to compare, understand, and interpret the original texts and annotations of Yixuerumen in an attempt to verify these through anatomy reference texts and computer programs. Results : In Yixuerumen, some contents of the networks of five viscera were revised to see feixi as not one but two, and explained the relationship of intestinal organs through heart and lung. Anatomically speaking, the networks of five viscera has a vertical structure that unfolds top to bottom centering on aorta, and has many organs connected to it such as trachea, esophagus, splenic artery, pulmonary trunk, ureter, mesentery arteriovenous, gonadal artery, and ductus deferens. Conclusions : The networks of five viscera has a great significance in that it is the fruit of much efforts where oriental medicine tried to explain not only the functions of five viscera, but also the creation and circulation of qi, blood, and bodily fluids through anatomical observation.

Arterial Switch Operation for Transposition of The Great Arteries with Ventricular Septal Defect and for Double Outlet Right Ventricle with Subpulmonary Venricular Septal Defect (심실중격결손증을 동반한 대혈관 전위증 및 양대동맥 우심실 기시증에 대한 동맥전환술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1118-1127
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    • 1990
  • Arterial switch operation for repair of nineteen cases of transposition of the great arteries associated with ventricular septal defect and three cases with double outlet right ventricle with subpulmonary ventricular septal defect[Taussig-Bing type DORV] was performed from November 1987 to September 1990 at the Seoul National University Children`s Hospital. Sixteen of them were under six months of age, and three were under one year of age with body weight ranged from three to fourteen kilograms. Preoperative cardiac catheterization was done in eighteen patients, in which the pressure of the left ventricle was greater than 70% of the right ventricle in all but one. Patent ductus was associated in thirteen cases[68.4%] of TGA+VSD, and atrial septal defect or patent oval foramen was in sixteen cases. Four atrial septostomy, one modified Blalock- Taussig shunt, one pulmonary artery banding, one coarctoplasty using subclavian arterial flap, were perfomed before arterial switch operation. There were five hospital deaths, all in the. patients with transposition of the great arteries with ventricular septal defect[overall mortality rate 22.7%]. Lecompte Maneuver was used in all patients, and in all patient the U-shaped flap of coronary arteries were transposed to V-shaped cleavage created in the neoaorta. Arterial defect in the neopulmonary artery was covered with 0.0625% Glutaraldehyde fixed autogenous pericardium There have been no late deaths, Postoperative cardiac catheterization and angiocardiogram in four patients has revealed no stenosis in the neopulmonary artery or neoaorta with reasonable P[RV/LV], Anatomic correction for transposition and double outlet right ventricle with subpulmonary ventricular septal defect would seem to be a good operative alternative to intraatrial switch procedures, with the advantage of incorporating the left ventricle to systemic circulation.

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Extracorporeal Life Support in Treatment of Poisoning Patient: Systematic Review (체외 생명유지술을 이용한 중독 환자의 치료: 체계적 고찰)

  • Lee, Yong Hee;Ko, Dong Ryul;Kong, Taeyoung;Joo, Young Seon;You, Je Sung;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.1
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    • pp.1-8
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    • 2016
  • Purpose: Extracorporeal life support (ECLS) is a term used to describe a number of modalities including extracorporeal membrane oxygenation (ECMO) to support cardiac and/or pulmonary systems. The purpose of this study is to review the available evidence regarding the effect of ECLS in patients with acute poisoning. Methods: Electronic literature searches with PubMed, Embase, Cochrane library, and KoreaMed were conducted for identification of relevant studies addressing ECLS in treatment of acute poisoning. The literature search was conducted by two investigators in March, 2016 with publication language restricted to English and Korean. The toxic substance, technique of ECLS, and final outcome of each case were analyzed. Results: The final analysis included 64 articles including 55 case reports. There were no articles classified according to a high level of evidence such as randomized trial and prospective cohort study. ECLS treatment was used in the management of patients poisoned with 36 unique substances. Venovenous ECMO was performed in 4 cases. Among the reported cases, 10 patients died despite treatment with ECLS. Conclusion: Evidence supporting ECLS for patients with acute poisoning is inadequate. However, many case reports suggest that early consideration of ECLS in poisoned patients with refractory cardiac arrest or hemodynamic compromise refractory to standard therapies may be beneficial.

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Successful Rescue of Refractory Ventricular Tachycardia after One and a Half Repair in Ebstein's Anomaly by Extracorporeal Membrane Oxygenation (부분 양심실 교정을 받은 엡스타인 기형에서 발생한 심실성 빈맥에 대해 체외막 산소화 장치를 이용한 성공적인 구출)

  • Seo, Hong-Joo;Whang, Sung-Wook;Lee, Cheul;Lim, Hong-Gook;Yu, Jai-Kun;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.220-224
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    • 2007
  • Extracorporeal membrane oxygenation (ECMO) provides mechanical cardiopulmonary support and has been used for children with severe respiratory failure, intractable heart failure, sepsis, pulmonary hypertension, and as a bridge to heart transplantation. There have been few reports of the use of ECMO to provide cardiac support in children with low cardiac output as a result of arrhythmias. We report the case of a 15-year-old female with circulatory collapse due to refractory ventricular arrhythmia after one and a half repair in Ebstein's anomaly, who was successfully resuscitated using ECMO.

Research about pulse diagnostic technique out of "Nan Jing hoeju jeonjung" ("난경회주전정(難經滙注箋正)"중(中) 맥진(脈診)에 관한 연구(硏究))

  • Park, Keun-Jung;Yoon, Chang-Yeol
    • Journal of Haehwa Medicine
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    • v.15 no.2
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    • pp.39-52
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    • 2006
  • We came to the conclusion as follows from the research about pulse diagnostic technique (脈診) out of "Nan Jinghoeju jeonjung" (難經滙注箋正). 1. "Nan Jing" is practical medical book for clinician and holds different opinions about three portions and nine takings(三部九候脈法) from Huang Di Nei Jing's Taking the pulse of Bu Jung Chim Chon Kwan Chuk((浮中沈 寸關尺) is a quite creative means which has been a important role to future generation. 2. We pointed the differences between western medical science and traditional medical science. And can explain the pulse in western medicine divided from twelve channels of Oriental Medicine. We can explain special connection between heart and lungs using the theory of systemic & pulmonary circulation in western medicine. And this can be a basement of Lung controls every pulse theory in oriental medicine. 3. We have negative assertion about viewing the human body using theory of Yin and Yang-Five Elements. And have poor opinion of explaining about the matching internal organs to Chon Kwan Chuk using the theory of Yin and Yang-Five Elements. 4. We pointed out the mistake that Porak & Sang hwa act for heart. We took pulses considering heart is a real actual internal organ as others. 5. We denied the theory of Man's Chuk pulse is always weak(男子尺脈恒弱) & Woman's Chuk pulse is always strong(女子尺脈恒盛). The physical form of man and woman is not different from each other considering their inheritances from forefather & same shape of organs. So, we cannot insist on the theory.

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Successful Removal of Intravenous Leiomyomatosis with Extension into Inferior Vena Cava and Right Atrium (하대정맥, 우심실에 연장된 정맥내 평활근종증의 성공적 절제)

  • Shin Hong Ju;Song Kwang Jae;Hahm Shee Young;Kim Young Tak;Seo Joon Beom;Song Meong Gun
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.441-444
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    • 2005
  • Abdominal tumors that can grow through vascular lumen and spread to the right heart are rare. Intravenous leiomyomatosis is a rare tumor that originates from the uterus and spreads through the vessels. Although histologically benign, tumor extension with mechanical obstruction of the inferior vena cava, right cardiac cavities, or even the pulmonary artery, may occasionally result in fatal outcome. The best treatment is complete surgical resection of the entire tumor using cardiopulmonary bypass and total circulation arrest, We report a case of intravenous leiomyomatosis of the uterus that showed intravascular growth up to the right atrium. The patient underwent successful resection of the tumor by one-stage cardiotomy with laparotomy.

Management of Acute Fulminant Myocarditis Using a Left Ventricular Assist Device - A case report - (좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 -)

  • Kang, Shin-Kwang;Park, Sang-Soon;Na, Myung-Hoon;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Seong, In-Whan
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.490-493
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    • 2001
  • A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.

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Time Course of Ventricular Remodeling after Atrial Septal Defect Closure in Adult Patients

  • Bae, Yo Han;Jang, Woo Sung;Kim, Jin Young;Kim, Yun Seok
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.45-52
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    • 2021
  • Background: Atrial septal defect (ASD) is the most common congenital heart disease. However, the details of cardiac chamber remodeling after surgery are not well known, although this is an important issue that should be analyzed to understand long-term outcomes. Methods: Between November 2017 and January 2019, cardiac magnetic resonance imaging was performed preoperatively, at a 1-month postoperative follow-up, and at a 1-year postoperative follow-up. Cardiac chamber volume, valve regurgitation volume, and ejection fraction were measured as functions of time. Results: Thirteen patients (10 men and 3 women) were included. The median age at surgery was 51.4 years. The preoperative median ratio of flow in the pulmonary and systemic circulation was 2.3. The preoperative mean right ventricular (RV) end-diastolic volume index (EDVi) and RV end-systolic volume index (ESVi) had significantly decreased at the 1-month postoperative follow-up (p<0.001, p=0.001, respectively). The decrease in the RVEDVi (p=0.085) and RVESVi (p=0.023) continued until the postoperative 1-year follow-up, although the rate of decrease was slower. Tricuspid valve regurgitation had also decreased at the 1-month postoperative follow-up (p=0.022), and continued to decrease at a reduced rate (p=0.129). Although the RVEDVi and RVESVi improved after ASD closure, the RV volume parameters were still larger than the left ventricular (LV) volume parameters at the 1-year follow-up (RVEDVi vs. LVEDVi: p=0.016; RVESVi vs. LVESVi: p=0.001). Conclusion: Cardiac remodeling after ASD closure is common and mainly occurs in the early postoperative period. However, complete normalization does not occur.

Influencing factors for Sleep Disturbance in the Intensive Care Unit Patients: A Systematic Review (중환자실 환자의 수면에 영향을 미치는 요인: 체계적 고찰)

  • Cho, Young Shin;Joung, Sunae
    • Journal of Korean Critical Care Nursing
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    • v.16 no.2
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    • pp.1-14
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    • 2023
  • Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

Using CT to Evaluate Cardiac Function (CT를 이용한 심장 기능 검사)

  • Jongmin Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.308-326
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    • 2024
  • A comprehensive evaluation of cardiac function includes information in relation to cardiac output and systemic venous return. The heart is composed of four chambers: two atria and two ventricles, each with its own unique mechanical function. These four cardiac chambers, their valves, and the pulmonary circulation system are inter-related as they preload or afterload on each other. Cardiac dysfunction is a failure of global cardiac function, resulting in typical clinical manifestations. To investigate the underlying cause of cardiac dysfunction, a step-by-step evaluation of cardiac blood flow tracks is necessary. In this context, imaging markers showing details of the cardiac structures have an important role in assessing cardiac function. An image-based evaluation allows for investigation of function in terms of individual cardiac components. Evaluation of cardiac function using cardiac CT has recently been validated. This review aimed to discuss cardiac CT-based imaging markers for comprehensive and detailed cardiac function assessment.