• Title/Summary/Keyword: 심실 세동

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Resternotomy for Recurrent Aortic Aneurysm Adherent to the Sternum Under Deep Hypothermic Circulatory Arrest (흉골에 접한 재발성 대동맥류에서 초저체온 순환정지하에서의 흉골재절개)

  • Kim, Sang-Heon;Kim, Young-Hak;Kim, Hyuck;Chung, Won-Sang;Kang, Jung-Ho;Jee, Heng-Ok;Lee, Chul-Bum
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.108-111
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    • 2004
  • Reoperation on the recurrent aortic aneurysm adjuvent to sternum remains a challenging problem in regard to the risk of the massive hemorrhage at the time of resternotomy resulting from inadvertent entry into the aneurysmal sac. The cardiopulmonary bypass technique of femoral cannulation and deep hypothermic circulatory arrest can provide a safe resternotomy. The left ventricle is likely to distend due to lack of contraction with ventricular fibrillation during core cooling. To prevent ventricular distention during core cooling, sufficient venous drainage is mandatory, We report a technique in which deep hypothermic circulatory arrest is achieved before resternotomy without left ventricular distention by active venous drainage using centrifugal pump.

Analysis of an External Stimulator's Impact on the Heart (체외 전기자극기가 심장에 미치는 영향의 분석 및 평가)

  • Kim, Mun-Soo;Choe, Seung-Wook
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.11
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    • pp.1213-1217
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    • 2011
  • Electric stimulators are used for various treatments, such as for pain relief and to improve rehabilitation in and out of the hospital. However, if the stimulation pulse affects the patient's heart, it can cause critical cardiac disorders such as arrhythmia or ventricular fibrillation. As a result, it must be ensured that the transmission length of the stimulation pulse does not exceed the proper range in the design of an electric stimulator. Furthermore, every anticipated risk factor must be monitored in in-vitro and in-vivo experiments. A new stimulator was designed to supply continuous 0.001 J stimulation pulses at a rate of 60 pulses per second. To evaluate the safety of the new electric stimulator and to measure its energy transfer and pulse transmission length, we built a conduction model that was filled with saline and measured the electric field at various positions in response to real stimulations. In an animal experiment with two pigs, heart disorders were induced by applying electric stimulation to tissues near the heart. These heart disorders were different from the result obtained with 9 V DC stimulation.

Coronary Blood Flow Disturbance of a Single Coronary Artery in a Patient Undergoing Aortic Valve Replacement - A case report - (단일관상동맥환자에시 대동맥판막 치환술 시행 중 발생한 관상동맥혈류장애의 치험 - 1예 보고 -)

  • Jung, Hee-Suk;Lee, Jae-Won;Jung, Sung-Ho
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.774-776
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    • 2009
  • A 57-year-old man with dyspnea was transferred to our institution. Echocardiography demonstrated grade III aortic valve regurgitation with a bicuspid aortic valve. The preoperative coronary angiography showed a left single nary artery. Replacement of the aortic valve was performed. Ventricular fibrillation developed during weaning patient of cardiopulmonary bypass after aortotomy repair. An anomalous origin of the coronary arteries is an incidental finding. However, in patients who are undergoing aortic valve replacement, a can significantly complicate the procedure. If this is present, then it is imperative that the clearly identified and the required procedure should be modified to avoid injury to these.

Development of Holter ECG Monitor with Improved ECG R-peak Detection Accuracy (R 피크 검출 정확도를 개선한 홀터 심전도 모니터의 개발)

  • Junghyeon Choi;Minho Kang;Junho Park;Keekoo Kwon;Taewuk Bae;Jun-Mo Park
    • Journal of the Institute of Convergence Signal Processing
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    • v.23 no.2
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    • pp.62-69
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    • 2022
  • An electrocardiogram (ECG) is one of the most important biosignals, and in particular, continuous ECG monitoring is very important in patients with arrhythmia. There are many different types of arrhythmia (sinus node, sinus tachycardia, atrial premature beat (APB), and ventricular fibrillation) depending on the cause, and continuous ECG monitoring during daily life is very important for early diagnosis of arrhythmias and setting treatment directions. The ECG signal of arrhythmia patients is very unstable, and it is difficult to detect the R-peak point, which is a key feature for automatic arrhythmias detection. In this study, we develped a continuous measuring Holter ECG monitoring device and software for analysis and confirmed the utility of R-peak of the ECG signal with MIT-BIH arrhythmia database. In future studies, it needs the validation of algorithms and clinical data for morphological classification and prediction of arrhythmias due to various etiologies.

Sinus Node Function after Extended Transseptal Approach for Mitral Valve Surgery: 164 Clinical Cases (경중격 절개방식을 좌심방 상부까지 연장시킨 방법을 통한 승모판막 수술 후 동방 결절 기능부전에 대한 164예 임상분석)

  • Ryu Se Min;Kim Hyun Koo;Cho Yang Hyun;Sim Jae Hoon;Sohn Young-sang;Choi Young Ho;Kim Hark Jei
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.214-220
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    • 2005
  • Extended transseptal approach can provide an excellent view of the mitral valve but the safety of this approach is controversial because this incision requires transaction of the sinus node artery, which in most cases and can result postoperative arrhythmia. The purpose of this study was to evaluate perioperative and longterm conduction disturbances and the cardiac rhythms of patients who underwent an extended transseptal approach for mitral valve surgery. Material and Method: Postoperative cardiac rhythms were analyzed in the 164 consecutive patients who received mitral valve replacements with a extended transseptal approach between March 1992 and July 2003. Result: Of the 84 patients in normal sinus rhythm, 34 ($39\%$) had developed transient junctional rhythm and atrial fibrillation after operation, lasting less than 72 hours in most of cases. No intractable arrhythmias occurred. Most of these arrhythmia were not detected at the time of discharge and only 8 patients ($9\%$) had atrial fibrillation at discharge. Postoperative PR intervals increased for 1 week, then decreased within 2 weeks postoperatively, and returned to normal range by 6 months postoperatively. During the postoperative period, 4 of the 78 patients with preoperative atrial fibrillation developed normal sinus thythm. Conclusion: The post-operative arrhythmias were temporary and showed no significant complications after extended transseptal approach for the mitral valve surgery.

Growth of $LiTaO_3$ and Fe doped-LiTaO3 single crystal as holographic storage material (홀로그래피 소자재료 $LiTaO_3$단결정 성장)

  • 김병국;윤종규
    • 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.

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The Comparision of Right Anterolateral Thoracotomy and Median Sternotomy in the Atrial Septal Defect Repair. (심방중격결손증 수술에서 우전측부개흉술과 정중흉골절개술의 비교)

  • Kim, Hyuck;Kim, Sang-Heon;Kim, Young-Hak;Chung, Won-Sang;Kang, Jung-Ho;Lee, Chul-Beom;Jee, Heng-Ok;Kim, Nam-Soo;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.1-6
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    • 2003
  • Currently, atrial septal defect repair has been considered low risk operation duo to the development of open heart surgery Not only the operation itself, but also the cosmetic aspect is now focused. Though many methods exist as minimally invasive cardiac surgery in atrial septal defect repair, some surgeons advocate that right anterolateral thoracotomy is better than the others in the cosmetic aspect and we compared right anterolateral thoracotomy with median sternotomy. Material and Method: From January 1999 to August 2002, 43 patient underwent atrial septal defect repair by one operator, including 15 patients through right anterolateral thoracotomy(group A) and 15 patients through median sternotomy(group B) in Hanyang university Hospital. The data were randomized and operation outcomes were analyzed between these two groups. Result: The mean weight of group A was 38.77$\pm$15.57kg and 38.21$\pm$21.82kg in group B. In group A, mean operation (OP) time was 197.6$\pm$61.40min, mean cardiopulmonary bypass(CPB) time was 48.66$\pm$13.02min and mean fibrillation time or aortic cross clamp(ACC) time was 30$\pm$11.64min. In group B, mean OP time was 212.33$\pm$31.95min, mean CPB time was 55$\pm$12.10min, and mean fibrillation or ACC time was 29.33$\pm$9.04min. There was no significant differences in these two groups. In group A, mean mechanical ventilation time was 3.78$\pm$0.78 hours, mean postoperative ICU stay was 1.2$\pm$0.47 days and mean postoperative hospital stay was 10.20 41.08 days. In group B, mean mechanical ventilation time was 5.95$\pm$3.73 hours, mean post operative ICU stay was 1.41$\pm$0.61 days, and mean postoperative hospital stay was 12.20$\pm$3.55 days. There was no any significant difference in two groups. Group A had significantly lower mean thoracic and pleuropericardial drainage than group B (175.33$\pm$90.54cc vs 352.33$\pm$239.43cc, p<0.05). Complication was seen in one case in group B, transient 2nd degree A-V block. Conclusion: Right anterolateral thoracotomy was better than median sternotomy not only in cosmetic aspect but also in postoperative thoracic and pleuropericardial drainage, using the same instrument(p.0.05). But, right anterolateral thoracotomy was more technically difficult due to narrow operative field and we should be careful of aortic cannulation.

Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist (소아치과의사를 위한 심폐소생술과 소아고급생명구조술)

  • Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.243-255
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    • 2017
  • Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

Clinical Study of 80 Cases of Mitral Valve Operations Via Extended Transseptal Approach (확장시킨 경중격 절개방식을 통한 승모판 수술의 80례 임상 분석)

  • 김학제;황재준;최영호;손영상;김욱진;김태식;김현구
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1037-1042
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    • 1998
  • Background: Among the various techniques for the adequate exposure of the mitral valve, the extended transseptal approach is the essential prerequisite for accurate repair or replacement of the mitral apparatus. But the efficacy and safty of the extended transseptal approach has not determined in Korea yet. Materials and methods: Retrospective data of 80 consecutive patients, operated from September 1992 to July 1997 were reviewed. Seventy- eight patients underwent mitral valve replacement and 2 patients underwent excision of left atrial myxoma. Thirty-eight of 78 patients had other concomitant procedures such as aortic valve replacement(n=22), tricuspid annulopasty(n=14), coronary artery bypass graft(n=1) and closure of ventricular septal defect(n=1). Mean follow up was 23.3±15.0 months and total follow up was 1792 patient-months. Results: The hospital mortality rate was 3.8%(3 patients). Two deaths were due to low cardiac output and one due to postoperative bleeding of coagulopathy. Among the 46 patients who had atrial fibrillation preoperatively, 45 had atrial fibrillation postoperatively and 1 converted to sinus rhythm. All 34 patients who were in normal sinus rhythm preoperatively remained in sinus rhythm after the operation. Mean aortic cross clamping time was 62 minutes for isolated mitral procedure and 90 minutes for concomitant procedures. There were no specific complications related to this approach. Conclusions: We suggest that the extended transseptal approach is an easy and good method for mitral valve surgery, especially in patients with small sized left atrium.

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Effects of EAS Systems on Pacemakers and ICDs Malfunction (도난방지 시스템의 전자기장이 인공심장 박동기 등의 오동작에 미치는 영향)

  • Shim, Young-Woo;Kim, Jong-Jeong;Yang, Dong-In;Lee, Moon-Hyung;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.46 no.6
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    • pp.44-49
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    • 2009
  • EAS (electronic article surveillance) systems have increased rapidly for article surveillance. In this paper, the strength of the EMF (electromagnetic fields) of EAS systems were measured. Pacemaker and ICD were investigated for inappropriate response resulting from EM (electromagnetic) EAS systems. The strength of EMF and the response of pacemaker and ICD were measured in the inner left side, outer right sides and the center of gates of the 6.3 kHz and 14.25 kHz EAS systems at a height of 130cm. As the result, EMF of the EAS system using 14.25 kHz was stronger than that of 6.3 kHz. AU interferences were observed only for 14.25 kHz, and the noisy ECG was found in three static positions on the pacemaker. The ICD resulted in noise reversion and VF (ventricular fibrillation) both static and moving positions by the EMP of 14.25 kHz EAS system. Therefore, it is necessary to post a message warning radiation of EMF from every EAS systems and possible risk of pacemakers and ICDs.