• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.761-772
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• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.216-222
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• 2008

Background: Prosthetic annuloplasty rings are used for the reconstruction of the mitral valve annulus. However, there is controversy over the best ring to use for reconstruction. In this study, we evaluated the long term result of using a Teflon felt strip as an alternative to commercial rings. Material and Method: From 1996 to 2007, we enrolled 47 patients with pure mitral regurgitation greater than grade III. All patients had an ejection fraction of 40% or more. Patients with congenital heart disease or other valvular heart disease were excluded from this study. They were divided into two groups; the commercial ring group (Group CR) and the Teflon felt ring group (Group TF). Result: There was no mortality. The postoperative echocardiography showed no significant change in the overall ejection fraction (from $58.0{\pm}11.2%\;to\;42.8{\pm}8.4%$). There were no significant differences between the two groups with regard to morbidity, the reoperation rate and recurrence of mitral regurgitation greater than grade II. Conclusion: The long term results from this study showed that posterior mitral annuloplasty using Teflon felt had similar results compared to annuloplasty using commercial rings.

• Journal of the Institute of Convergence Signal Processing
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• v.9 no.1
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• pp.31-38
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• 2008

Ad-Hoc network is a network architecture which has no backbone network and is deployed temporarily and rapidly in emergency or war without fixed mobile infrastructures. All communications between network entities are carried in ad-hoc networks over the wireless medium. Due to the radio communications being extremely vulnerable to propagation impairments, connectivity between network nodes is not guaranteed. Therefore, many new algorithms have been studied recently. This study proposes the secondary header approach to the cluster based routing protocol (CBRP). The primary header becomes abnormal status so that the primary header can not participate in the communications between network entities, the secondary header immediately replaces the primary header without selecting process of the new primary header. This improves the routing interruption problem that occurs when a header is moving out from a cluster or in the abnormal status. The performances of proposed algorithm ACBRP(Advanced Cluster Based Routing Protocol) are compared with CBRP. The cost of the primary header reelection of ACBRP is simulated. And results are presented in order to show the effectiveness of the algorithm.

• Proceedings of the Ginseng society Conference
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• 1988.08a
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• pp.77-80
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• 1988

The effects of ginseng saponins and some phenolic acids on the in vitro biosynthesis of prostaglandins was examined in order to identify the role of some ginseng components on the regulaion of arachidonic acid metabolism. The productions of prostaglandin $E_2(PGE_2).$ prostaglandin $F_2{\alpha}(PGF_2{\alpha}).$ thromboxane $B_2(TxB_2)$ and 6-keto-prostaglandin $F_1{\alpha}(6-keto-PGF_1{\alpha})$ from $[^3H]-arachidonic$ acid were evaluated with rabbit kidney microsome. human platelet homogenate and bovine aortic microsome. The amounts of the total cyclooxy-genase products from arachidonic acid did't show significant changes in the presence of ginseng saponins. Panaxadiol. panaxatriol and all of the ginsenosides used in these experiments reduced the formation of $TxB_2.$ while increased the $6-keto-PGF_1{\alpha}$ production dose dependently. Ginseng saponins did't inhibit the ADP($10{\mu}M$) induced platelet aggregation. but sodium arachidonate (0.5 mM) induced platelet aggregation. but sodium arachidonate (0.5 mM) induced platelet aggregation was signiticantly inhibited. These findings suggest that ginseng saponins seem to playa role in the regulation of the arachidonate metabolism. probably by affecting the divergent biosynthetic pathway of prostaglandins from endoperoxide.

• Journal of Korea Entertainment Industry Association
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• v.13 no.2
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• pp.197-205
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• 2019

This study was to compare arterial stiffness and hemodynamic responses between male smokers and non-smokers. This study also investigates the influences of smoking before exercise on arterial stiffness and hemodynamic responses. 24 male subjects of age 20-29 without history of cardiorespiratory disease were divided into smokers and non-smokers. Smokers had more than 5 years of smoking experience. In order to evaluate the effects of pre-exercise smoking, smokers were tested twice, once with a cigarette before the exercise and the other once without one. Data was collected from bio-impedance analysis, SphygmoCor XCEL, graded exercise test, and fitness test. Main results of this study are as follows: First, there are differences between smokers and non-smokers in cardiorespiratory and hemodynamic response functions, as shown by maximal oxygen consumption, exercise duration, and heart rate. Second, the although the arterial stiffness between smokers and non-smokers showed statistically significant differences in the speed of the pulse wave velocity and augmentation index, smoker had a faster rate. It shows that smoking behavior has a negative impact on the cardiovascular system. Third, pre-exercise smoking behavior does have an impact on cardiorespiratory and hemodynamic response functions, as shown by exercise duration and heart rate. Lastly, arterial stiffness between smokers and non-smokers showed statistically not significant in the speed of the pulse wave velocity and augmentation index. However, the difference was not statistically significant. Brachial systolic pressure, a component of pulse wave analysis, on the other hand, was significantly dependent on pre-exercise smoking behavior. Subjects who participated in this study are college students in early 20s. Given their relatively short history of smoking, it is possible that their smoking habits are not severe enough to develop into cardiorespiratory or cardiovascular diseases. But Smokers showed lower levels of cardiopulmonary functions, as maximal oxygen consumption and exercise duration than nonsmokers.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.568-572
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• 2008

Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.677-682
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• 2004

Takayasu's arteritis is a chronic inflammatory disease that primarily affects large vessels, such as the aorta and its main branches. Pulmonary artery is often involved in Takayasu's arteritis, but only a few cases have been reported in which pulmonary artery involvement occurred as the initial clinical manifestation. We report one patient who was referred to our institution with the provisional diagnosis of chronic thromboembolic pulmonary hypertension and subsequently diagnosed with Takayasu's arteritis involving the pulmonary artery.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.850-860
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• 1996

Oxygen free radicals and their metabolites have been implicated as possible causes of reperrusion injury In animal models. Their role in the clinical setting is still controversial. The aim of this study was to evaluate the degree of tissue damage, oxidative stress. and changes in the antioxidant enzyme system in patients undergoing cor nary artery bypass graft operations(CABG) with myocardial protection by cold blood cardioplegia. In patients undergoing CABG(n:10). the levels of lactate dehydrogenate(LDH), creatine phosphokinase MB fraction(CK-MB), and malondialdehyde(M DA) were measured In the coronary sinus effluent before aortic cross clamping and 20 minutes after reperfusion. At the same time, the myocardial tissue activities of superoxide dismutase(SOD). catalase(CAT), glutathione peroxiddse(GSHPX), glutathione reductase (GSSGRd), and glucose 6-phosphate dehydrogenate(GfPDH ) were determined in the right atrial auricle excised before aortic cross clamping and in the left atrial auricle excised 20 minutes after reperfuslon. The levels of increased significantly after reperrusion(p< U.05). There were no significant changes in CAT and CfPDH levels. Western blot analysis was performed to study the induction of antioxidant enzyme and demonstrated increased amount of Cu,Zn-SOD.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.931-938
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• 1998

Background: Anatomic correction of transposition of the great arteries by means of the arterial switch operation is now accepted as the therapeutic method of choice. This retrospective study attempts to assess the results of the neonatal arterial switch operation for transposition of the great arteries performed by our newly established institution. Materials and methods: 33 consecutive neonates underwent the arterial switch operation between October 1991 to November 1997. There were 27 neonates with transposition and intact ventricular septum, 3 with ventricular septal defect, and 3 with Taussig-Bing anomaly. The mean age was 10.9$\pm$7.9 days and mean body weight was 3.29$\pm$0.44kg. Results: Overall postoperative hospital mortality was 30.3% (10 patients). The mortality has improved with time; 75% (6 patients) among first 8 consecutive patients before 1994, 20% (2 patients) among 10 patients in 1994 and 1995, and 13.3% (2 patients) among 15 patients since 1996. Univariated analysis of risk factors revealed that earlier date of the operations and one of preoperative events were determinants for operative death. There were two late deaths. A mean follow-up of 17.4$\pm$16.5 months was achieved in all 21 survivors. All were in New York Heart Association functional class I. One patient had mild pulmonary stenosis and two had mild aortic valve regurgitation on their echocardiography. Conclusions: We concluded that we should continue to perform arterial switch operation for neonates with transposition of the great arteries because the mortality of the operation has been improved and the operative survivors have good functional results with low incidence of late complications.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1031-1036
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• 1998

Background: Medtronic-Hall mechanical valve is a world widely using prosthesis. But, in Korea, the clinical result from Medtronic-Hall valve replacement is not frequenthy available. Materials and methods: From March 1986 to May 1990, 50 patients underwent valve replacement surgery with Medtronic-Hall valve at Pusan National University Hospital. Seventeen were male and thirty three were female and ra nging in age from 16 to 70 years of age(mean=35 years). Results: The causes of valvular lesion were rheumatic in 43 patients, bicuspid aortic valve in 3 patients, degenerative lesion in three patients and bacterial endocarditis in one patient. The operative procedures were mitral valve replacement(MVR) in 38, aortic valve replacement(AVR) in 5 and double valve replacement(DVR) in 7. The most commonly used valve size was 21mm in AVR, 29mm in MVR. Concomitant surgical procedures were performed in 15 patients; left atrial thrombectomy in 9, left atrial auricle obliteration in 6 and tricuspid annuloplasty in 5(Kay: 2, DeVega: 3). New York Heart Association functional class was mostly Class Ⅲ or Ⅳ(91.5%) preoperatively and ClassⅠor Ⅱ(87.2%) after operation. The findings of postoperative echocardiogram of LAD, LVESD, LVEDD were reduced compared with preoperative period and ejection fraction was increased compared with preoperative period. Postoperative complications were massive bleeding in three, low cardiac output syndrome in two, thromboembolism in one and fulminant hepatitis in one patient. There were three hospital deaths and their causes were low cardiac output syndrome in two and rupture of left ventricle in one patient. The 5 year survival rate was 93.65±0.71% and 10 year actuarial survival rate was 88.27±6.42%. Conclusions: Medtronic-Hall mechanical valve has low valve related complication rate. It's durability and hemodynamic performance is comparable to other mechanical valves.