• Journal of Chest Surgery
• /
• v.39 no.1 s.258
• /
• pp.12-17
• /
• 2006

Background: Circulatory arrest under deep hypothermia is an important auxiliary means for surgical correction of total anomalous pulmonary venous connection (TAPVC), However, cardiac operations under deep hypothermic circulatory arrest are associated with the risk of post-arrest neurologic abnormalities. The purpose of this study is to evaluate the results of the surgical correction of total anomalous pulmonary venous connection without the total circulatory arrest. Materiai and Method: Between April 2000 and October 2004, hospital records of 10 patients were reviewed retrospectively. Result: The locations for abnormal anatomical connections were supracardiac in 7 cases, cardiac in 1 case, and infracardiac in 2 cases. The mean cardiopulmonary bypass time and aorta cross clamp time were 116.8$\pm$40.7 and 69.5$\pm$24.1 minutes. There was no surgical mortality. Postoperative complications were post-repair pulmonary venous stenosis in 1 case, pneumonia in 1, pneumothorax in 1, wound infection in 1,and diaphragmatic paralysis in 1. All patients without pulmonary venous stenosis were in NYHA class I at mean follow-up of 16.6 months (3$\∼$49 months) Conclusion: We could obtain excellent results by repair without the total circulatory arrest for total anomalous pulmonary venous connection.

• Journal of Veterinary Clinics
• /
• v.29 no.5
• /
• pp.416-421
• /
• 2012

A 10-year-old 4-kg spayed female Chihuahua with severe congestive heart failure was referred for surgical treatment. Through several examinations, the dog was diagnosed as severe mitral regurgitation (MR) and moderate TR. Because of the poor prognosis associated with continuation of medical management, surgical repair of the mitral valve was considered as the treatment option for the dog. The mitral valve repair was performed undergoing cardio pulmonary bypass (CPB) circuit. However after mitral repair, the dog was died without recovery from anesthesia. Many risk factors associated with failure of cardiac surgery are included CPB management, hypothermia, organ dysfunction, hemorrhage, hypotension, electrolyte & acid base imbalance, and infection. Although the dog is died from the operation, it is an important to reveal the factors of failure in veterinary clinic. From the case report, causes of failure of mitral valve repair can be considered from the failure of oxygenation and gas exchange by hypothermia and serious hypotension with low heart rate by low cardiac output syndrome (LCOS). Through the several considerations from this case, it is known that coming cardiac surgery for mitral valve repair is required to be more careful for successful operation. Further it can be brought to increase success rate in further operation.

• Journal of Chest Surgery
• /
• v.39 no.5 s.262
• /
• pp.366-375
• /
• 2006

Background: Hypomagnesemia is a common complication after cardiac surgery with cardiopulmonary bypass. The purpose of this study was to assess the clinical beneficial effect of administration of magnesium sulfate in cardiac surgery. Material and Method: Thirty five patients scheduled for elective cardiac surgery were randomly assigned to magnesium group (n=20) which received magnesium sulfate in priming solution (1 g) and cardioplegic solution (1 g) or control group (n=15) which did not receive it. Arterial blood samples were drawn for measuring $Mg^{++}$ and electrolytes contents, blood gas analysis, CBC, total protein, albumin, blood urea nitrogen (BUN), creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, tumor necrosis factor-${\alpha}$ $(TNF-{\alpha})$, interleukin-6 (IL-6), interleukin-10 (IL-10), creatine phosphokinase (CpK), creatine kinase-MB (CK-MB), lactate dehydrogenase(LDH), troponin-1 (TNI), prothrombin time (PT) and activated pratial thromboplastin time level (aPTT). Venous blood samples were drawn before and after the operation for measuring activated clotting time level (ACT). Result: $Mg^{++}$ levels in magensium group were higher than those of control group at intraoperative and post-operative periods (p<0.05). dysrhythmias were lower in magnesium group (8 cases out of 17 patients, 46.4%) than in control group (10 cases out of 10, 100%, p=0.050). Conclusion: These results showed that administration of low dose magnesium sulfate during cardiac surgery prevented hypomagnesemia and lowered incidence of dysrhythmia.

• Journal of Chest Surgery
• /
• v.32 no.2
• /
• pp.130-137
• /
• 1999

Background: In cardiac surgery, hypothermia is associated with a number of major disadvantage, including its detrimental effects on enzymatic function, energy generation and cellular integrity. Warm cardioplegia with normothermic cardiopulmonary bypass cause three times more incidence of permanent neurologic deficits than the cold crystalloid cardioplegia with hypothermic cardiopulmonary bypass. Interruptions or inadequate distribution of warm cardioplegia may induce anaerobic metabolism and warm ischemic injury. To avoid these problems, tepid blood cardioplegia was recently introduced. Material and Method: To evaluate whether continuous tepid blood cardioplegia is beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Warm group(37$^{\circ}C$) consisted of 18 patients who underwent valvular surgery with continuous warm blood cardioplegia. Tepid group(32$^{\circ}C$) consisted of 17 patients who underwent valvular surgery with continuous tepid blood cardioplegia. Result: Heartbeat in 100% of the patients receiving continuous warm blood cardioplegia and 88.2% of the patients receiving continuous tepid blood cardioplegia converted to normal sinus rhythm spontaneously after removal of the aortic cross clamp. There were no differences between these two groups in CPB time, ACC time, the amount of crystalloid cardioplegia used and peak level of potassium. During the operation, the total amount of urine output was more in the warm group than the tepid group(2372${\pm}$243 ml versus 1535${\pm}$130 ml, p<0.01). There were no differences between the two groups in troponin T level measured 1hr and 12hrs after the operation. Conclusion: Continuous tepid blood cardioplegia is as safe and effective as continuous warm blood cardioplegia undergoing cardiac valve surgery in myocardial protection.

• Journal of Chest Surgery
• /
• v.34 no.9
• /
• pp.698-703
• /
• 2001

Background: Endovascular stent-graft insertion in aortic diseases is now generally accepted as an attractive alternative treatment modality. We reviewed our clinical experiences of endovascular stent-graft insertion in thoracic aorta. Material and Method: Since 1995, we performed 8 cases of endovasclar stent-graft insertion. Preoperative diagnoses were aortic aneurysms in 4, traumatic aortic ruptures in 3, and ruptured aortic pseudoaneurysm in 1. All procedures were performed in angiography room with the guidance of fluoroscopy. The stent-graft device is a custom-made 0.35mm thickness Z-shaped stainless steel wires, intertwined with each other using polypropylene suture ligation. It is covered with expanded Dacron vascular graft. Result: All procedures were performed successfully. Follow-up studies revealed 2 minimal perigraft leakages. There was no significant leakage or graft migration. 2 patients expired due to multiple organ failure and fungal sepsis. Other survivors(6) are doing well. Conclusion: Endovascular stent-graft insertion is relatively saft and effective treatment modality in the managment of various types of aortic diseases. In may be an effective alternative in aortic diseases of great surgical risk.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.55-60
• /
• 2008

Background: Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure. The aim of our study was to investigate whether preoperative and postoperative BNP levels could predict postoperative complications and outcomes in patients after coronary artery bypass graft (CABG). Material and Method: Data was collected prospectively on 30 patients (M/F=19/11, age $60.0{\pm}9.6$ years) undergoing conventional CABG during a 1-year period beginning on January 1, 2005. Patients underwent off-pump CABG, and combined surgery was excluded. The BNP assay was performed preoperatively, immediate postoperatively at the intensive care unit (ICU), and 1, 3, 5, and 7days postoperatively. Result: Preoperative BNP levels significantly correlated with preoperative echocardiographic ejection fraction and an ICU stay of 5 days or more (r=-0.4, p=0.028; r=0.39, p=0.031, respectively). A preoperative BNP cut-off value above 263 pg/mL demonstrated high specificity (90.5%) for predicting postoperative complications using the receiver operating characteristics curves. Preoperative and postoperative (7 days) BNP levels were different depending on the abscence (mean BNP=$99{\pm}23\;pg/mL$ vs. $296{\pm}74\;pg/mL$, p<0.05) and presence (mean BNP=$212{\pm}29\;pg/mL$ vs. $408{\pm}23\;pg/mL$, p<0.01). Conclusion: Preoperative BNP levels >263 pg/mL predict postoperative complications in patients receiving CABG.

• Korean Journal of Microbiology
• /
• v.37 no.4
• /
• pp.284-288
• /
• 2001

Respiratory viruses are one of the most infectious agent in human. Six different respiratory tract viruses were detected from Busan while working on the preventive surveillance in 1997-2000. The isolation rate from suspected specimens were 8.4%. Influenza virus A, B type, parainfluenza virus, adenovirus, mumps virus, and measles virus were examined from throat swabs, serum, and secretions of patients. Influenza A/Sydney/05/97(H3N2)-like, A/Johanesburg/33/94(H3N2)-like, A/Beijing/262/95(H1N1)-like and Influenza B/Beijing/262/95-like, B/Harbin/07/94-like, B/Guangdong/08/93-like were found. Adenovirus serotype 1, 2, 3 and 5 were detected, antibody of mumps both IgM and IgG were shown and outbreaks of measles were confirmed. Different antigenic types of influenza virus were detected every year, one outbreak of parainfluenza in 1999, mumps outbreak in 1999 and 2000, and incidence of measles in 2000 were noticeable. Monthly outbreaks were November through following March with influenza virus, January through June with adenovirus, February through May and December with mumps, April through August and November, December with measles, respectively. The size of isolated viruses were 130 nm with influenza virus B type, non-enveloped, icosahedron with 70 nm with adenovirus, 170 nm with mumps virus and 180 nm with parainfluenza virus in diameter, respectively.

• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1077-1082
• /
• 1997

To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

• Journal of the Korean Applied Science and Technology
• /
• v.38 no.1
• /
• pp.318-331
• /
• 2021

This study was conducted on the assumption that bone age would be more effective when it comes to physique and physical fitness assessment for adolescents, and the purpose of this study was to identify the differences in physique and physical fitness for students in their adolescence through bone age and chronological age in order to contribute to the well-balanced physique and physical fitness development in adolescents and the health improvement in students. Total 874 adolescents(483 males, 391 females) aged 11~16 were selected as subjects out of the total population of 1100 adolescents aged 6~16 based on the PAPS(Physical Activity Promotion System) and age standards of the TW3 method; and skeletal maturation, which symbolize the indicators of biological maturation, were evaluated by using the TW3(Tanner-Whitehouse 3) method after hand-wrist radiographs, and birth date was used for chronological age. A stadiometer and InBody 270 (Biospace, Korea) were used to measure 2 components in physique. A total of 7 components in physical fitness, which included muscular strength, muscular endurance, flexibility, power, cardiovascular endurance, balance, agility, were measured as well. A independent samples t-test was conducted for data processing using SPSS 25.0, and the significance level was set at p< .05. The study results are as follows. First, bone age and chronological age used for physique comparison in males aged 11 and 12, height and weight showed significant difference; in males aged 13, weight showed signicant difference. Weight and height in females aged 11, and height in females aged 12 showed significant difference. Second, bone age and chronological age used for physical fitness comparison in males aged 11, muscular strength, power, flexibility, cardiovascular endurance showed significant difference; in males aged 12, muscular strength. power, cardiovascular endurance; in males aged 13, flexibility showed significant difference. Muscular strength, power, flexibility, muscular endurance, cardiovascular endurance in females aged 11, and flexibility in females aged 14 showed significant difference. As a result, this study concluded that in a period of rapid skeletal growth, evaluating physique and physical fitness based on bone age is more accurate than evaluating based on chronological age.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.4
• /
• pp.239-244
• /
• 2018

A 59-year-old man with no specific medical or family history complained of chest pain and became unconscious. A member of his family, who was a witness, called 119 and gave him dispatcher-assisted cardiopulmonary resuscitation, followed by defibrillation using an automated external defibrillator placed in his apartment. Afterward, he was given two sessions of defibrillation by the 119 emergency squad, then transferred to an emergency medical center with the return of spontaneous circulation. The patient was discharged with cerebral performance category (CPC) 1 15 days later. While dispatcher-assisted cardiopulmonary resuscitation and defibrillation is at its beginning stage in South Korea, this case seems to demonstrate its effectiveness. Moreover, this case suggests it can be particularly useful for helping untrained witnesses use an automated external defibrillator, which may have important implications in regions in which there are delayed responses of the 119 emergency squad to the site. It is also important to develop a plan for improving witness access to and quantitative supply of the South Korean public access defibrillation (PAD) program.