• Journal of Chest Surgery
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• v.37 no.11
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• pp.929-932
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• 2004

The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2018.10a
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• pp.438-440
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• 2018

Cardiac arrest is a series of conditions that occur when the heart is stopped, regardless of the cause. Cardiac arrest due to heart disease is included in the cause of death in korea every year and is unpredictable. One of the only ways to save a patient's life when a cardiac arrest is cardiopulmonary resuscitation is to maintain circulation through this procedure. The visual information is transmitted to the brain through the optic nerve. Among them, the mittor can see its movement and its shape, and it can be used for correction and analysis. Therefore compared the quality of chest compressions with visual information using mirrors. There was a significant difference in the mean depth of chest compressions($48.93{\pm}6.76$, $53.86{\pm}4.56$, <0.001), and there was also a difference in compression to relaxation ratio($0.87{\pm}0.13$, $0.96{\pm}0.10$, <0.002). There was also a significant difference in attitude awareness($4.93{\pm}0.85$, $8.14{\pm}1.38$, <0.001).

• Journal of Chest Surgery
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• v.35 no.6
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• pp.449-453
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• 2002

Intra-aortic balloon pump (IABP) is well known for its hemodynamic benefit but still has its own complications. Proper use of IABP is the best way to obtain maximum benefit with low complication rate. Material and Method： Twenty one(men 10, female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital. Eighteen(85.7%) were ischemic heart disease patients. They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications. Their preoperative conditions, intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. Result： Nineteen patients(90.5%) were successfully weaned from IABP. There were 2 patients of operative death and the mortality rate was 9.5%. Duration of IABP use was 40.7$\pm$24.3 hours. There were 2 cases(9.5 %) of IABP-related vascular complications that required surgical intervention. Conclusion： We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.698-703
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• 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 the Korea Academia-Industrial cooperation Society
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• v.19 no.10
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• pp.222-230
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• 2018

This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.518-524
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• 1999

Background: This study has proven the effect of modified ultrafiltration(MUF) performed after the cessation of cardiopulmonary bypass in pediatric patients who underwent open heart surgery. Material and Method: From Jan. to Dec. 1997, modified ultrafiltration was performed after cardiopulmonary bypass in 50 infants with cyanotic heart disease and the results were compared to the control group of 50 patients with cyanotic heart disease in whom modified ultrafiltration was not used. Changes of hematocrit, central venous pressure, systolic and diastolic pressure, heart rate and body weight were compared. Result: Age and body weight were not different(p=0.38, p=0.46). Disease categories were similar. Average filtering volume was 60.0$\pm$29.2cc/kg for 7.0$\pm$2.4minutes of filtration. Mean hematocrit after filtration(MUF=36.1%, control=26.4%, p=0.001) was higher in the MUF group. Systolic (p=0.0001) and diastolic blood pressure(p=0.0001) were observed to increase more and the central venous pressure(p=0.02) and the heart rate(p=0.02) were lower after filtration in the MUF group. Conclusion: This study demonstrated that modified ultrafiltration after cardiopulmonary bypass was a technically feasible option to improve the post-surgical course through the effective hemoconcentration, hemodynamic improvements, and body water control.

• Journal of Digital Convergence
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• v.15 no.1
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• pp.227-238
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• 2017

Cardiac arrest is a serious intensive emergency disease that causes death within less than several minutes by depriving the body and brain of blood supply. Survival rate of cardiac arrest patients outside of hospitals is especially low. This is because pedestrians usually do not perceive the patient as a sick person, also, even if they do so, they have no medical knowledge to properly react to such emergency. The purpose of this study is to propose a solution that uses widely spread smart phones to alert pedestrians of the cardiac arrest patient, prevents cardiac arrest, and provides first-aid measures. By applying the proposed solution, cardiac arrest can be prevented in advance, pedestrians can be alerted to keep the golden time(4 minutes), and first witness can quickly proceed with CPR, ultimately enhancing the survival rate of the cardiac arrest patient.

• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.386-393
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• 1999

Objective : Cardiopulmonary exercise testing in patients with heart and lung problems is used to assess functional capacity, evaluate responses to medical treatment, plan for exercise therapy, assess progression of disease process, and determine prognosis. Particularly in the patients with lung cancer, the exercise pulmonary function test gives significant physiologic assessment of the lung resection candidate. Common exercise modalities are running and cycling. Until now, the comparison of two tests mainly has been done in normal person and patients with cardiac diseases. This study is designed to compare the treadmill and bicycle exercise pulmonary function test in patients with respiratory diseases. Methods : Twenty one patients underwent a progressively incremental exercise test to the symptom-limited stage with the treadmill (Vmax29 Sensor Medics, USA) and the bicycle(model No. 2,900 Sensor Medics, USA) with 7 days apart between the two tests. Measurements were made of the metabolic, cardiorespiratory parameters, blood gases, and symptoms. Results : The results of the treadmill exercise showed significant elevation in the $VO_2$max, VEmax, and anaerobic threshold compared to those of bicycle exercise. In contrast, the results of the breathing and heart rate reserve showed the reverse. Conclusion : These results suggest that the type of exercise should be taken into consideration when interpreting exercise test in patients with respiratory diseases.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.349-356
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• 2005

Background: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG. Material and Method: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of $59.3\pm11.9$ years ($36\~83$). Mean ejection fraction was $55.4\pm14.0\%\;(15\~86).$ Angiography showed left main disease or triple-vessel disease in $81.9\%$ of the patients. Indications of using arterial conduits was stenosis $\ge50\%$ of left anterior descending artery, stenosis $\ge80\%$ of branches of left circumflex artery, and stenosis $\ge90\%$ of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates. Result: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were $2.86\pm0.78$. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients ($1.8\%$), renal failure in 4 patients ($1.2\%$), perioperative myocardial infarction in 3 patients ($0.9\%$), reoperation for bleeding in 3 patients ($0.9\%$). There was no postoperative stroke. Patency rate of arterial conduits was $99.3\%$ (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries. Conclusion: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.939-944
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• 1998

Background: The sugical results of the Cox-Maze procedure (CMP) for lone atrial fibrillation(AF) have proven to be exellent. However, those for AF associated with mitral valve(MV) disease have been reported to be a little inferior. Materials and methods: To assess the efficacy and safety of the CMP as a combined procedure with MV operation, we studied retrospectively our experiences. Between April 1994 and October 1997, we experienced 70 (23 males, 47 females) cases of CMP concomitantly with MV operation. Results: The etiologies of MV disease were rheumatic in 67 and degenerative in 3 cases. The mean duration of AF before sugery was 66$\pm$70 months. Fifteen patients had the past medical history of thromboembolic complications, and left atrial thrombi were identified at operation in 24 patients. Twelve cases were reoperations. Aortic cross clamp (ACC) time was mean 151$\pm$44 minutes, and cardiopulmonary bypass (CPB) time was mean 246$\pm$65 minutes. Concomitant procedures were mitral valve replacement (MVR) in 19, MVR and aortic valve replacement (AVR) in 14, MVR and tricupid annuloplasty (TAP) in 8, MVR with AV repair in 3, MV repair in 11, MVR and coronary artery bypass grafting (CABG) in 2, MVR and AVR and CABG in 1, redo-MVR in 10, redo-MVR and redo-AVR in 2 patients. The rate of hospital mortality was 1.4%(1/70). Perioperative recurrence of AF was seen in 44(62.9%), and atrial tachyarrhythmias in 10(14.3%), low cardiac output syndrome in 4(5.7%), postoperative bleeding that required mediastinal exploration in 4(5.7%) patients. Other complications were acute renal failure in 2, aggravation of preoperative hemiplegia in 1, and transient delirium in 1 patient. We followed up all the survivors for 16.4 months(3-44months) on an average. Sinus rhythm has been restored in 65(94.2%) patients. AF has been controlled by operation alone in 73.9% and operation plus medication in 20.3%. Two patients needed permanent pacemaker implantation; one with sick sinus syndrome, and the other with tachycardia- bradycardia syndrome. Only two patients remained in AF. We followed up our patients with transthoracic echocardiography to assess the atrial contractilities and other cardiac functions. Right atrial contractility could be demonstrated in 92% and left atrial contractility in 53%.We compared our non-redo cases with redo cases. Although the duration of AF was significantly longer in redo cases, there was no differences in ACC time, CPB time, postoperative bleeding amount and sinus conversion rate. Conclusions: In conclusion, the CMP concomitant with MV operation demonstrated a high sinus conversion rate under the acceptable operative risk even in case of reoperation.