• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.417-423
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• 2006

Purpose : The objectives of this study were to assess ventricular function by tissue Doppler imaging in children who were receiving chemotherapy or who had received chemotherapy, and to apply repeated tissue Doppler imaging to make an early assessment in cardiac toxicity studies. Methods : This study was conducted on 23 oncology patients on-treatment or off-treatment from April 2005 to July 2005 at Dongsan Medical Center, Keimyung University. All patients(group 1) were divided into two groups, fractional shortening(FS) over 29 percent(group 2) and FS under 28 percent (group 3) in the first category. These same patients were also divided into the following groups : group treated with anthracyclin(group 4) and group treated without anthracyclin(group 5). Deceleration time(DT), isovolumic relaxation time(IVRT), FS, peak early diastolic(E), and peak late diastolic (A) velocity of transmitral flow were measured by M-mode and pulsed wave Doppler. Systolic(Sm), peak early diastolic(Em), and peak late diastolic(Am) velocity in apical 4-chamber and 2-chamber views were measured by tissue Doppler imaging. The author calculated a modified Tei index, E/A, E/Em ratio by using measured values. Results : Twenty three patients were enrolled : 12 boys and 11 girls. The average age of patients was 8 years and 4 months. Thirteen out of 23 patients were in the group treated with anthracyclin (group 4) and 6 had FS under 28 percent(group 3). E/Em ratio showed a significant difference between group 1 and control group($6.46{\pm}1.85$ vs $7.06{\pm}1.64$, P<0.05). Other parameters had no difference statistically. Conclusion : This study showed that the change of cardiac function developed earlier in diastolic function than in systolic function, as E/Em ratio reflecting the mean LV diastolic pressure showed a significant difference between the control group and chemotherapy groups. Echocardiography using tissue Doppler imaging is a non-invasive, comfortable and reliable method for post-chemotherapy follow up.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.554-560
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• 2003

Purpose : To investigate the teratogenic effect of gamma-ray on the heart of chick embryo. Methods : 50 rad, 100 rad, 150 rad, 200 rad, 250 rad, and 300 rad of gamma-ray were used to irradiate three days old chick embryos. The control group was not irradiated. After three weeks, the embryos were sacrificed and examined for cardiovascular malformation. Results : The survival rate of the gamma-ray irradiated group was significantly lower than that of the control group(33.3-63.3% vs 76.4%, P=0.001). The cardiac malformation rate of the experimental group was 11.0%. In the control group, no congenital cardiac malformations were observed. The experimental groups had a significantly higher malformation rate(P=0.001). The types of malformation were ventricular septal defect, tricuspid atresia, Ebstein anomaly and aortic arch anomaly. In the gamma-ray irradiated group, the cardiac malformations were : 14 small ventricular septal defects (VSDs), five large VSDs, two tricuspid atresias, and one Ebstein anomaly. The higher the dose of radiation applied, the higher the incidence of cardiac malformation was noted. Conclusion : Gamma-ray irradiation of 3 days old chick embryos increased the rate of death and the rate of cardiac malformation significantly.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.876-882
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• 2003

Purpose : To find out the myocardial protective effect of cardioxane for the myocardial damage by doxorubicin. Methods : Using Eighteen rabbits(2.0-3.2 kg), doxorubicin($30mg/m^2$) was injected intravenously once a week in group I(12 rabbits) and cardioxane($600mg/m^2$) was injected at 20-30 minutes before doxorubicin administration in group II(6 rabbits). After this, we operated on the rabbits when the total cumulative dose of doxorubicin was reached at 210, 240, 270 and $300mg/m^2$ and observed the degree of myocardial damage with light and electronic microscope. Results : In group I, rabbits with less than $210mg/m^2$ of total cumulative dose of doxorubicin, there was no definite myocardial damage but with $240mg/m^2$, focal degenerative change was observed and with $300mg/m^2$, severe degenerative change was detected with light microscopic examination. With electronic microscope, rabbits with less than $180mg/m^2$ of total cumulative dose of doxorubicin in group I, there was no evidence of myocardial damage. In $210mg/m^2$, focal degenerative change was detected. With $240mg/m^2$, degenerative change was much more advanced and with $300mg/m^2$, severe degenerative change was detected. In group II, no definite myocardial damage was observed even though the total cumulative dose of doxorubicin reached $300mg/m^2$, but with $360mg/m^2$, there was a focal area where myocardial fibers were somewhat decreased, but it's difficult to say whether these decrement were due to adriamycin in the electronic microscopic examination. Conclusion : Cardioxane have a good protective effect for the doxorubicin induced cardiomyopathy and it will be used safely in pediatric cancer patients.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1147-1158
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• 1998

Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.495-503
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• 1999

Background: We tested the technical feasibility of fetal cardiac bypass and collected baseline data on the fetal hemodynamics and placental functions related to the cardiopulmonary bypass in the fetal lamb model. Material and Method: Eleven fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Eight served as a group in which placenta was excluded from the extracorporeal circulation by clamping the umbilical cord during the bypass(the oxygenator group) and in the remaining three, the placenta worked as the only source of oxygen supply(the placenta group). Observations were made every 10 minute during a 30-minute bypass and 30-minute post bypass period. No prostaglandin inhibitors were used both in ewes and in fetuses. Result: Weights of the fetuses ranged from 1.9 to 5.2 kg. In the oxygenator group, means of arterial pressure, PaO2, atrial pressure, heart rate, and bypass flow rate ranged 69.8 to 82.6 mmHg, 201.7 to 220.9 mmHg, 4.1 to 4.3 mmHg, 169 to 182/min, and 140.3 to 164.0 ml/kg/min, respectively during bypass, but rapid deterioration of the fetal cardiac functions and the placental gas exchange was observed after the cessation of bypass. In the placenta group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of PaCO2 increased from 61.9 to 129.6 mmHg during bypass. Flow rate was suboptimal(74.3 to 97.0 ml/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. Conclusion: In this study, the technical feasibility of fetal cardiopulmonary bypass was confirmed in the fetal lamb model. However, further studies with modifications of the bypass including an addition of prostaglandin inhibitor, an application of the total spinal anesthesia on the fetus, a creation of more concise bypass circuit, and a use of active pump are mandatory to improve the outcome.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.364-374
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• 2010

Background: We assessed the early and mid-term results of the modified Norwood procedure for first-stage palliation of hypoplastic left heart syndrome (HLHS) and its variants to identify the risk factors for hospital mortality. Material and Method: Between March, 2003, and December, 2009, 23 patients (18 males and 5 females) with HLHS or variants underwent the modified Norwood procedure. The age at operation ranged from 3 to 60 days (mean, $11.7{\pm}13.2days$) and weight at operation ranged from 2.2 to 4.8 kg (mean, $3.17{\pm}0.52kg$). We used a modified technique that spared the anterior wall of the main pulmonary artery in 20 patients. The sources of pulmonary blood flow were RV-PA conduit in 15 patients (group I) and RMBTS in 8 (group II). Follow-up was completed in 19 patients (19/20, 95%) in our hospital (mean $26.0{\pm}22.8months$). Result: Early death occurred in 3 patients (3/23, 13%), of whom 2 had TAPVC. Fourteen patients underwent subsequent bidirectional cavopulmonary connection (BCPC, stage 2) and seven underwent the Fontan operation (stage 3). Three patients died between stages, 2 before stage 2 and one before stage 3. The estimated 1-year and 5-year survival rates were 78% and 69%, respectively. On multivariate regression analysis, aberrant right subclavian artery (RSCA) and associated total anomalous pulmonary venous connection (TAPVC) were risk factors for hospital mortality after stage 1 Norwood procedure. Conclusion: HLHS and its variants can be palliated by the modified Norwood procedure with low operative mortality. Total anomalous pulmonary venous connection adversely affects the survival after a stage 1 Norwood procedure, and interstage mortality rates need to be improved.

• Journal of the Korean Crystal Growth and Crystal Technology
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• v.8 no.2
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• pp.193-204
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• 1998

The single crystal of the $LiTaO_3$has large electro-optic effects, so it is applied to optical switch, acousto-optic deflector, and optical memory device as hologram using photorefractive effect. In this study, optic-grade undoped $LiTaO_3$and Fe:LiTaO$LiTaO_3$single crystals were grown by the Czochralski method and optical transmission and absorption spectrums were measured in the wavelength of UV-VIS range. The curie temperature was determined with DSC and by measuring capacitance for the grown undoped crystal and ceramic powder samples of various Li/Ta ratio. In case of having a 48.6 mol% $Li_2O$ as a starting Li/Ta ratio, the results of concentration variations were below 0.01 mol% $Li_2O$ all over the crystal, so it was confirmed that $LiTaO_3$single crystals were grown under congruent melting composition having optical homogeneity. The curie temperature of the Fe:$LiTaO_3$crystal was increased with increased with increased doped Fe concentrations;by the ratio of $7.5^{\circ}C$ increase per Fe 0.1 wt%. Also, the optical transmittance was about 78 %, which was sufficient for optical device.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.609-617
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• 1999

Background: The aims of this study were to assess the etiologies, survival and prognostic factors of patients with chronic cor pulmonale visited Pusan National University Hospital. Methods : This study included 103 patients with chronic cor pulmonale. There were 67 men and 36 women. The diagnosis of chronic cor pulmonale was primarily based on the presence of underlying lung disorder and echocardiographic finding of enlarged or hypertrophied right ventricle. Other clinical data including patients' symptoms and signs, findings of arterial blood gas analysis, hematologic and biochemical laboratory and pulmonary function test were assessed. Results: The most common underlying lung disorder was pulmonary tuberculosis(59.2%) and chronic obstructive pulmonary disease was the next(28.2%). The survival rate was 57% in one year, 45% in two years, and 34% in three years. The prognostic factors were maximal voluntary ventilation(MVV), forced vital capaoity(FVC), $FEV_1$ serum Na, vital capacity(VC), serum albumin and peak expiratory flow(PEF) in univariate analysis. And in multivariate analysis, serum albumin(p=0.0144) and VC(p=0.0078) were statistically significant. Conclusion: Pulmonary tuberculosis was the most important underlying lung disorder in chronic cor pulmonale. The survival rate was 57% in one year, 45% in two years, and 34% in three years. Serum albumin (p=0.0144) and VC(p=0.0078) were statistically significant prognostic factors.

• Journal of Bio-Environment Control
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• v.26 no.1
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• pp.1-6
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• 2017

The paprika has emerged as one of the highest-income crops by increase in dimestic and export demand in the greenhouse crops. Nevertheless, there is no standard for fertigation in soil, because general culture system is soilless culture. This study was conducted to establish the optimum nitrogen and potassium application level for paprika fertigation. Four different levels of nitrogen and potassium were applied, treatment levels were 0.5, 1.0, 1.5, 2.0 times of pimiento fertilization recommendations based on soil testing. Experiment to instigate the optimum amounts of nitrogen and potassium were carried out in 2012 and 2013, respectively13. Nitrogen application : stem diameter of 0.5 times was significantly lower than other treatments, but stem length was not affected by nitrogen fiertigation levels. Number of fruit and yield of first fruiting group harvest were not significant difference. but those of the second fruiting group were decreased by increasing nitrogen level beyond 1.0 times treatment and were the lowest in 0.5 times treatment. Overall, the optimum level of nitrogen for fertigation was judged 1.0 times of pimiento fertilization recommendations based on soil testing. Potassium application : Growth was no signigicant trend except stem length. Number of locule, fresh thickness and sugar content were not significant difference. Number of fruit and yield were not significant difference at the first and second fruiting group harvest. But those were significant difference at third fruiting group harvest, maximum yield was obtained by 1.5 times fertigation level. The optimum level of potassium for fertigation was judged 1.5 times of pimiento fertilization recommendations based on soil testing.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.1012-1017
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• 2008

Purpose : This study aimed to assess the mechanical properties of the abdominal aorta in school-aged patients treated for Kawasaki disease and in normal, healthy children. Methods : This study examined 28 children with Kawasaki disease who had been followed up on and 30 healthy subjects of the same age and gender. We recorded systolic (Ps) and diastolic (Pd) blood pressure values and the aortic diameter at both minimum diastolic (Dd) and maximum systolic (Ds) expansion using two-dimensional echocardiography. These measurements were used to determine 1) aortic strain: S=(Ds-Dd)/Dd; 2) pressure strain elastic modulus: Ep=(Ps-Pd)/S; and 3) normalized Ep: $Ep^*=Ep/Pd$. Results : Ep (P=0.008) and $Ep^*$ (P=0.043) of the Kawasaki disease group were relatively high compared to those of the control group. Ep (P=0.002) and $Ep^*$ (P=0.015) of patients with coronary aneurysm were also relatively high compared with those of patients without coronary aneurysm, but lipid profiles did not differ, except for homocysteine (P=0.008). Therefore, in patients with coronary aneurysm, aortic stiffness was higher, compared to not only the control group but also patients without coronary aneurysm. However, in patients without coronary aneurysm, aortic stiffness was not significant, different compared to the control group. Conclusion : Measuring aortic distensibility may be helpful in assessing the risk of early atheroscletic change in the long-term management of Kawasaki disease.