• Journal of Chest Surgery
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• v.41 no.6
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• pp.703-709
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• 2008

Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.18-24
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• 2013

Purpose: Myocardial perfusion SPECT using $^{201}Tl$ is an important method for viability of left ventricle and quantitative evaluation of cardiac function and now various reconstruction methods are used to improve the image quality. But in case of small sized heart, you should always be careful because of the Partial Volume Effect which may cause errors of quantitative indices at the reconstruction step. So, In this study, we compared those quantitative indices of left ventricle according to the reconstruction method of myocardial perfusion SPECT with the Echocardiography and verified the degree of the differences between them. Materials and Methods: Based on ESV 30 mL of Echocardiography, we divided 278 patients (male;98, female;188, Mean age;$65.5{\pm}11.1$) who visited the Asan medical center from February to September, 2012 into two categories; below the criteria to small sized heart, otherwise, normal or large sized heart. Filtered and output each case, we applied the method of FBP and OSEM to each of them, and calculated EDV, ESV and LVEF, and we conducted statistical processing through Repeated Measures ANOVA with indices that measured in Echocardiography. Results: In case of men and women, there were no significant difference in EDV between FBP and OSEM (p=0.053, p=0.098), but in case of Echocardiography, there were meaningful differences (p<0.001). The change of ESV especially women in small sized heard, significant differences has occurred among FBP, OSEM and Echocardiography. Also, in LVEF, there were no difference in men and women who have normal sized heart among FBP, OSEM and Echocardiography (p=0.375, p=0.969), but the women with small sized heart have showed significant differences (p<0.001). Conclusion: The change in quantitative indices of left ventricle between Nuclear cardiology image reconstruction, no difference has occurred in the patients with normal sized heart but based on ESV, under 30 mL of small sized heart, especially in female, there were significant differences in FBP, OSEM and Echocardiography. We found out that overestimated LVEF caused by PVE can be reduced in average by applying OSEM to all kinds of gamma camera, which are used in analyzing the differences.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.807-815
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• 1996

The protective effect of'ischemic preconditioning'on ischemid-reperfusion injury of heart has been reported in various animal species. but without known mechAnism in detail, In An attempt to investigate the cardioprotective mechanism of ischemic preconditioning, we examined the effects of nitric oxide(UO) synthesis in preconditioned heart of rat The isolated hearts perfused by Langendorfr's method were ex- posed to 30min global ischemia followed by 30min reperfusion with oxygenated Krebs-Henseleit(K-H) sol- ution. Ischemic preconditioning was performed with three episodes of Sm n ischemia and Smin repeyfusion before the induction of prolong ischemia(30min)-reperfusion(30min). Ischemic preconditioning prevented the depression of cardiac function(left ventricular pressure .K heart rate) observed in the ischemia- reperfusion hearts and reduced the release of lactate dehydrogenase during the reperfusion period. On electromicroscopic pictures, myocardial ultrastructures wore relatively well preserved in isthemic preconditioned hearts. N6_nitro-L-arginine methyl ester(L-NAME) an inhibitor of L-arginine citric oxide pathway, was infused at a rate O.Smllmin In a dose of 10mg kg-1 before the initial ischemic preconditioning. neither the protection of cardiac function nor the reduction of LDH releAse in ischemic preconditioning hearts was altered in the presence of added L-NAME On ultrastructural finding, the preservation of morphology in ischemic preconditioning heart was not change by the pretreatment of L-UAME. The failure of the WO synthesis inhibitor to reduce t e effect of ischemic preconditioning may be related to be species specific in that NO may allot be the trigger for ischemic preconditioning in rats.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.1-10
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• 1997

The successful cardiac transplantation depends partly on the donor heart preservation by a solution that will ensure recovery of myocardial function. The purpose of this study was to perform the evaluation of various preservation solutions and to accumulate the data on the requisites for ideal preservation solution. The experimental setup was the constant pressure Langendorffs perfusion system. Isolated rabbit hearts were perfused for 20minutes with unarm Krebs-Henseleit solution, stored for 4 hours in cold preservation solution after cardioplegia, and then were reperfused for 20minutes. The 4 experimental groups were prepared Hartmann's solution group (group 1, control), modified Euro-collins solution group(group II. MEC), modified University of Wisconsin group (group n, MUW), and CK solution(made by the author) group (group W, CK). The parameters for assessing the preservation ability were levels of enzymes in freezed myocardial tissues (lactate, creatine kinase-MB and adenosine deaminase), coronary flow. left ventricular developing pressure and dpldt. In conclusion, the ability of preservation for isolated rabbit heart was excellent in CK solution and modified University of Wisconsin solution, and poor in modified Euro-collins solution, compared with Hartmann solution. CK solution has low potassium concentrations(34.2mEq/L) and includes various substrates to be salutary on myocardial preservation. This fact may indicates the necessity of further refinements in selection or composition of electrolytes and substrates.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3319-3325
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• 2013

In this paper, hand acupuncture used as a way of life medicine in everyday life, the influence of human organ will be investigated by applying IT techniques. For this, hand acupuncture is based on priority of the most important organ in the human body to target the cardiac associated with cardiac reflex point A16 acupuncture point before and after for 5 min to stimulation of facial images were collected and applied to the Lab color system associated with the cardiac, color value of cheonjung and lips region were measured for comparison and analysis. Finally, by measuring the change in bio-image signals A16 acupuncture point stimulation effects on cardiac function were performed to investigate the effectiveness of acupuncture. Also, statistical significance tests from the experimental results were performed whether the experimental results is valid or not.

• Journal of the Korean Society of Radiology
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• v.14 no.6
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• pp.791-800
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• 2020

Ultrasonography is widely used to evaluate the function of fetal heart, but due to the subjective nature of the test, there are differences in measurement methods for each examiner, and especially the myocardial performance index has no reference index to date. Therefore, in this study, we wanted to analyze pulse Doppler waveforms of normal fetuses and develop an automatic measurement program to make objective measurements. One hundred and thirty-three pregnant women who visited the hospital for prenatal examinations were studied, myocardial performance index was measured after acquiring a pulse doppler image of the left ventricle. As a result, the early, mid and late pregnancy myocardial performance index, measured by the automatic measurement program conducted in this study, was found to increase as pregnancy continued.

• Journal of Biomedical Engineering Research
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• v.23 no.2
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• pp.131-137
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• 2002

The remote monitoring system including hemodynamic information and pump status of the implanted animal could be helpful during the in vivo experiment or clinical trial for an artificial heart Implantation. In order to monitor the course of the in vivo experiment continuously and anywhere, web-based remote monitoring system was developed, which can monitor pressures(AoP, LAP, RAP, PAP) and flow information as well as the pump operating conditions. The system consists of data sending, storing viewer part. The data sending part was constructed using component object model and the viewer part was constructed using the Java applet. In addition, the dialog box was introduced to communicate earth other instantly and the alarming function was also introduced when the hemodynamic values were out of the desired ranges. The developed remote monitoring system was applied during the in vivo experiment of the BVAD (Bi-ventricular Assist Device) implantation for 1 month and showed designed work without failure.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2016.10a
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• pp.915-918
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• 2016

Virtual testing devices are required due to rapid changes in the health care industry and the increase of the medical or nursing workforce. The importance of devices such as the simulator, blood vessels, and lab equipment for modeling blood flow to the heart is increasing too. In this study, we made heart pump by using a step motor and developed device which simulates arterial, venous blood pressure, and blood flow. We finally evaluated the function of proposed device. The proposed system is composed of the pump for simulating, the valve device to describe the resistance of the artery and vein, and a reducing device showing the characteristics of the venous system. We used BOXER pump for heart simulator and silicon tube for arterial and venous vessels, and designed a reducing device. We also used the pressure sensor to measure arterial blood pressure. For the evaluation of the proposed system, we selected a range of 50~100mmHg of the blood circuit 60 per minute and then compared the blood pressure of a person and the measured blood pressure.

• Journal of Chest Surgery
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• v.34 no.11
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• pp.809-822
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• 2001

Background: Ischemic preconditioning(IP) is known to be effective in the protection of myocardial necrosis, arrhythmia, and the restoration of the myocardial function in the ischemia-reperfusion state of the heart. However the exact mechanism is not clearly understood. The purpose of this study was to elucidate the trigger mechanism 7f IP on the restoration of the myocardial function after ischemia-reperfusion. Material and Method: By connecting a Langendorff perfusion apparatus with an isolated heart of a rat, the normal temperature of the heart was maintained. The experiment was conducted in seven groups, which were divided according to the preconditioning stimuli and blockage methods Group I(n=10) was a group without IP, Group II(n=10) a group of three-minute IP, Group III(n=10) a group of PEIP, Group IV(n=10) a group of clonidine IP, Group V(n=10) a group of If after reserpine, Group Vl(n=10) a group of PE & prazosin IP, and Group Vll(n=10) a group of clonidine & yohimbine IP. Hemodynamic parameters of DP, LVEDP, $\pm$dP/dT and the changes of perfusion in the coronary artery were evaluated. Result: Developed pressure and +dP/dT changed per unit time. After 20 minutes of reperfusion, those of Group II and III were 63.1$\pm$3.7%, 64.8$\pm$4.6% and 64.5$\pm$4.6%, 63.8$\pm$4.4%, which improved more significantly than those of Group I(P<0.05), However, there were no significant differences between the Groups V and Vl, and Group I. Conclusion: The Brief ischemic preconditioning and pharmacological preconditioning using $\alpha$-receptor sympatho-mimetics have protecting effects on the restoration of myocardial function after reperfusion. And the protecting effect of preconditioning seems to be related to sympathetic neurotransmitters and to the selective action of the $\alpha$$_1$-adrenergic receptor.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.773-780
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• 1999

Background: It has been demonstrated that brief periods of calcium depletion and repletion (calcium-free preconditioning, CP) have cardioprotective effects as seen in ischemic preconditioning(IP) which enhances the recovery of post-ischemic contractile dysfunction and reduces the incidence of reperfusion-induced arrhythmia or infarct size after a prolonged ischemia. In the present study, we tested this paradoxical phenomenon in isolated rabbit hearts. Material and Method: Hearts isolated from New Zealand white rabbits(1.5∼2.0 Kg body weight) were perfused with Tyrode solution using the Langendorff technique. After stabilizing the baseline hemodynamics, the hearts were subjected to 45 minutes of global ischemia followed by 120 minutes of reperfusion with IP(IP group, n=7) or without IP (ischemic control group, n=7). IP was induced by a single episode of 5 minutes global ischemia and 10 minutes reperfusion. In the CP group(n=7), the hearts were subjected to perfusion with Tyrode solution with calcium depletion for 5 minutes and repletion for 10 minutes, and 45 minutes of ischemia and 120 minutes of reperfusion. Left ventricular function including developed pressure, dP/dt, heart rate, left ventricular end-diastolic pressure and coronary flow was measured. Infarct size was determined by staining with 1% triphenyltetrazolium chloride and planimetry. Data were analyzed by a one-way analysis of variance and Tukey's post-hoc test. Result: In comparison with the ischemic control group, IP significantly enhanced the recovery of the left ventricular function including the left ventricular developed pressure, contractility, and coronary flow; in contrast, these functional parameters of the CP group tended to be lower than those of the ischemic control group. However, the infarct size was significantly reduced by IP or CP(p<0.05). Conclusion: These results suggest that in isolated Langendorff-perfused rabbit heart model, CP(induced by single episode of 5 minutes calcium depletion and 10 minutes repletion) could not improve the post-ischemic contractile dysfunction(after a 45-minute global ischemia) but it has an infarct size-limiting effect.