• Journal of Chest Surgery
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• v.34 no.3
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• pp.252-255
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• 2001

본 30세 여환은 류마치스성 심장판막질환 진단하네 승모판막 및 대동맥판막 치환술 시행후 종격동염 발생하여 지속적 종격동 세척 및 3주간의 항생제 치료후 퇴원하였다. 외래 추적중 다시 감염 및 염증소견 보여 입원하여 혈액배양검사와 흉부전산화 단층촬영시행하였다. 검사상 종격동염의 이후 3주간의 항생제 치료에도 염증 소견이 지속되어 다시 시행한 흉부 전산화단층촬영상 상행대동맥에 거대 가성대동맥류소견보여 재개흉술을 시행하여 초저체온 완전 순환정지 하에 가성대동맥류를 절제한 후, 우심낭편을 이용하여 대동맥 성형술을 시행하였다. 수술후 환자는 순조롭게 회복하였으며 현재 외래에서 추적관리하고 있다.

• Transactions of the Korean Society of Mechanical Engineers
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• v.16 no.11
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• pp.2090-2097
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• 1992

In this paper, fluttering behavior of mechanical monloleaflet heart valve prosthesis was analyzed taking into consideration of the impact between the valve occluder and the stopper. The motion of valve occluder was modeled as a rotating system, and equations were derived by employing the moment equilibrium conditions. Lift force, drag force, gravity and buoyancy were considered as external forces acting on the valve occluder. The 4th order Runge-Kutta method was used to solve the equations. The results demonstrated that the occluder reaches steady eguilibrium position only after damped vibration. The mean damping ratio is in the range of 0.197-0.301. Fluttering frequency does not have any specific value, but varies as a function of time. It is in the range of 11-84Hz. Valve opening appears to be affected by the orientation of the valve relative to gravitational forces.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.7-26
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• 2020

Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.205-221
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• 2021

Purpose: This paper is to determine whether automatic defibrillators (AEDs) deployed across communities make a contribution to prevent death in patients with acute cardiac arrest out-of-hospital. Methods: A total of 30,179 cases of cardiac arrest investigation data from the Korea Centers for Disease Control and Prevention was matched to those on emergency medical statistics drawn from annual report for the 2018 Central Emergency Medical Center, and statistics from the National Statistical Office in 2018. Results: Multiple logistic regression analyses revealed that availability of emergency medical resources across associated with different survival rates at emergency room after taking variability of the patient's personal characteristics and episodic situational characteristics held constant. The survival rate was 1.71 times higher for patients living in communities with more than 105 AEDs avaiable per 100,000 inhabitants than for those living in communities with less than 55 AEDs. Conclusion: The survival-related factors of patients with acute cardiac arrest that occurred out-of-hospital were found to be associated with patients' and episodic situational characteristics. The hospital stage were found to be associated with patients characteristics and episodic situational characteristics, The variability of AED available in a community has an impact on survival rate after emergency room treatment.

• Journal of Korean Medical classics
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• v.19 no.4
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• pp.113-125
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• 2006

주씨재(周氏在) "독의수필(讀醫隨筆) 기혈정신론(氣血精神論)" 중개괄정기신지총의위(中槪括精氣神之總義爲): 기자(氣者), 무형이유기자야(無形而有機者也). 이기기지소동(以基機之所動), 유삼초지분출야(有三焦之分出也). 정자(精子), 유형자야(有形者也). 유형칙유질(有形則有質), 이기질지소별(以其質之所別), 유사등지부동야(有四等之不同也). 신자(神者), 무형무기이유용자야(無形無機而有用者也). 이기용지소성(以其用之所成), 고추견오성지대본야(故推見五性之大本也). 개괄정기신지분류여소주위(槪括精氣神之分類與所主爲): 기유삼(氣有三), 왈종기야(曰宗氣也), 영기야(榮氣也), 위기야(衛氣也), 주어명문(主於命門); 정유사(精有四), 왈정야(曰精也), 혈야(血也), 진야(津也), 액야(液也), 주어신(主於腎); 신유오(神有五), 왈신야(曰神也), 혼야(魂也), 백야(魄也), 의여지야(意與智也), 지야(志也), 시오장소장야(是五臟所藏也), 주어심이복종어담(主於心而復從於膽). 개괄정기신삼자적상호관계위(槪括精氣神三者的相互關係爲): 대기자(大氣者), 정지어야(精之御也); 정자(精者), 신지택야(神之宅也); 신자(信者), 기여정지화야(氣與精之華也). 주씨인위(周氏認爲): 위기위열기(衛氣爲熱氣), 영기위습기(營氣僞濕氣), 종기위동기(宗氣爲動氣), 고위기유한열병(故衛氣有寒熱病), 영기유습병(營氣有濕病) 조병(燥病), 종기유욱결병(宗氣有郁結病), 유노권병(有勞倦病). 혈지질최중탁(血之質最重濁); 진지질최경청(津之質最經淸); 액지질청이정영(液之質淸而晶瑩), 후이응결(厚而凝結), 중이불탁(重而不濁); 정지질극청극후(精之質極淸極厚), 이우극령(而又極靈); 인신당중(人身當中), 혈위최다(血爲最多), 정위최중(精爲最重), 이진지용위최대(而津之用爲最大); 정혈진액지병변다표현위부족혹허탈(精血津液之病變多表現爲不足惑虛脫). 심장신(心藏神), 폐장백(肺藏魄), 간장혼(肝藏魂), 비장의여지(脾藏意與智), 신장지(腎藏志). 오신이혈기위용(五神以血氣爲用), 내장어오장(內藏於五臟), 외현위희(外顯爲喜) 노(怒) 사(思) 우(憂) 공지오지(恐之五志). 신지병변불가측(神之病變不可測), 차우최불역치(且又最不易治), 총이조신여안정위근본치신지법(總以調神與安靜爲根本治神之法).

• The Korean Journal of Emergency Medical Services
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• v.20 no.2
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• pp.7-19
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• 2016

Purpose: To investigate the effect of early hypothermia on post-resuscitation myocardial recovery and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction(MI). Methods: Thoracotomies were performed in 10 male Sprague Dawley rats weighing 450-455g. Myocardial infarction was induced by ligation of the left anterior descending coronary artery. Ninety minutes after arterial ligation, ventricular fibrillation was induced, cardiopulmonary resuscitation was subsequently performed before defibrillation was attempted. Animals were randomized to control group and experimental group(acute MI-normothermia)($32^{\circ}C$ for 4 hours). Duration of survival was recorded. Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured using echocardiography. Results: Myocardial function was significantly better in hypothermia group than the control group during the first 4 hours post-resuscitation. The survival time of the experimental group was greater than that of the control group(p<.050). Conclusion: This study suggests that early hypothermia can attenuate post-resuscitation myocardial dysfunction after acute myocardial function, and may be a useful strategy in post-resuscitation care.

• Progress in Medical Physics
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• v.24 no.4
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• pp.278-283
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• 2013

Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.

• The Korean Journal of Pharmacology
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• v.26 no.2
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• pp.121-126
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• 1990

The contractility of isolated rat atria, suspended in Krebs-Ringer bicarbonate medium containing 5.5mM glucose, was depressed approximately 50% by 0.1 mM of lidocaine. Partial recovery of the lidocaine-depressed contractility was achieved by the metabolizable substrates pyruvate, acetate, and fructose, but not by addition of glucose. Glucose produced the dose-dependent increase in the force of contraction of normal atria, whereas pyruvate, acetate, and fructose produced no significant effect in the contractile activity of the normal atria. In the absence of exogenous glucose lidocaine produced more marked depression of atrial contractility than that in the presence of exogenous glucose. The results of this study may confirm that the utilization of cardiac glycogen is also inhibited by lidocaine at sites of the glucose phosphate isomerase step or step between glycogen to glucose-6-phosphate.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1066-1075
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• 1996

To compare the efficacy of cardiac preservation, we examined purine metabolites during 24 hours of cold storage($0^{\circ}C$) of the Korean ongrel dog hearts after using three different types of cardioplegic solutions. The hypothermic arrest with total cardiopulmonAry bypass method was employed in 51. Thomas solution(575) and blood cardioplegic solution(BCPS) preservation cases. Specimens were analyzed for levels of adenine nucleotides and their precursors by high performance liquid chromatography. The ATP content in the UW(University of Wisconsin) solution group tends to be higher than that of the combined hypothermic arrest group(575 and BCPS groups) after 2,4,8, and 12 hours of preservation respectively, but there were no significant differences between 575 and BCPS groups. The ADP contents in the UWS and BCPS groups were higher than that of the 575 group at 4,8, 12, and 24 hours, but the difference was not statistically significant between UWS and BCPS groups. The AMP contents did not change significantly in the three groups. The adenosine, Inosine, and hypoxanthine concentrations increased progressively, but the lev l of xanthine was very low in the three groups.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.353-361
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• 1998

Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.