• Journal of Chest Surgery
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• v.37 no.8
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• pp.660-664
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• 2004

Background: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. Material and Method: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4 : 1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. Result: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346$\pm$597 mL in dilutedplegia (mean$\pm$standard deviation, and 28$\pm$9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21$\pm$4% in dilutedplegia and 24$\pm$3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250$\pm$810 mL, 1689$\pm$548 mL) than in microplegia (959$\pm$410 mL, 1461$\pm$784 mL; p<0.05). Conclusion: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.

• Parasites, Hosts and Diseases
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• v.30 no.3
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• pp.201-208
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• 1992

A Theileria sergenti soluble merozoite preparation containing the 29, 34, 35 and 105 KD as the immunodominant polypeptides, was evaluated for efficacy, safety and protectivity in Holstein calves against virulent field tick challenge. The soluble antigens (100 mg/dose) were fortified with either complete or incomplete Freund's adjuvant. Twenty naive calves, aged one month, were subcutaneously inoculated with the preparation and a booster dose was administered 4 weeks later. Twenty additional calves served as controls. Five weeks after the booster dose, vaccinates and uninoculated controls were moved to a pasture, a heavily tick infested area in Cheju-do, Korea. The vaccinates showed negligible change in hematocrit and total RBC count whereas control animals showed significant (p<0.05) hematological changes and associated anemia. Only 30% of vaccinates required chemotherapy after the experiment was terminated. All control animals required chemotherapy and 25% received blood transfusion. The highest percent parasitized erythrocytes in vaccinated cattle was 0.4% as compared with 3.6% among controls during the month of July. A significant difference (p<0.05) was observed in the rate of body weight increase. Significant difFerences were also noted in serum albumin, aspartate aminotransferase, total protein and bilirubin. Significantly more vaccinated cattle maintained normal ranges of hematological and biochemical values as compared with the control group. It is suggested that soluble merozoite T. sergenti antigens may be potential vaccine candidates for developing a genetic vaccine in Korea.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.107-114
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• 2020

This study was conducted to examine the effects of simulation-based education on the clinical reasoning competence, clinical competence, and satisfaction with simulation experience (SSE). The research design was one group pretest-posttest. Study participants were 89 third-year nursing students from C University in G city, who were engaged the simulation-based education for eight weeks from August to October 2019. Learning scenario titles were blood transfusion reaction patient care with postoperative total hip replacement, hypoglycemia patient care with diabetes mellitus, and hyperkalemia patient care with liver cirrhosis. The data were analyzed by paired t-test using SPSS Win 23.0 program. After applying simulation-based education, nursing students' clinical reasoning competence (t=-17.082, p<.001) and clinical competence(t=-18.40, p<.001) improved significantly. SSE score was 4.65 out of 5 points. The results indicate that the simulation-based education in this study gave the students the experience of providing qualified and secure nursing care under conditions similar to those in the real clinical field. To improve the clinical reasoning competence and clinical competence of nursing students, various cases scenarios are developed and simulation-based education should be applied to more subjects in the nursing curriculum.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.4-15
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• 1983

The laryngeal carcinoma is the most frequent malignant tumor in the E.N.T. field. In the surgical treatment of laryngeal carcinoma, in 1873, Billroth performed the first total laryngectomy, and in 1863, H. B. Sands performed the first partial laryngectomy. Recently general advances (antibiotic therapy, blood trasfusion, and safer anesthesia) result in the improvement of postoperative prognosis. Because the laryngeal lymphatic system has the characteristic compartmentation, this serves the anatomic basis for performing the partial laryngectomy. Although the indications of partial laryngectomy are different from that of total laryngectomy, the partial laryngectomy has the advantage of not only removal of all malignant disease, but also maximum preservation of respiratory, phonatory, and sphincteric function of the larynx. In the latest, surgical treatment decreased the frequency of recurrence, and also increased the 5 year survival rate with combination of the chemotherapy and radiation therapy. The authors have experienced 8 cases of partial laryngectomy for laryngeal carcinoma at the department of otolaryngology, Korea University Hospital from 1980 to 1982. Among the total 8 cases, 2 cases were involved only in the epiglottis, 2 cases in the anterior 1/3 of both vocal cords with ant. comissure, 2 cases in the middle 1/3 of Lt. vocal cord, 1 case in the anterior 1/3 of Rt. vocal cord with ant. comissure, and another 1 case in the Rt. ventrical. So authors report these cases with review of the literature.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.655-662
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• 2010

Background: Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized as an option to achieve a cure. We retrospectively analyzed over a 6 year period the surgical outcomes, the complications and the mortality-related factors for patients with abdominal aortic aneurysms. Material and Method: We analyzed 36 patients who underwent surgery for abdominal aortic aneurysms between May 2001 and June 2005, and between April 2007 and November 2009. The indications for surgery were rupture, a maximal aortic diameter > 50 mm, and medically intractable hypertension or pain. Result: The mean patient age was $69.67{\pm}6.97$ years (range: 57 to 84 years). Thirty two patients (88.9%) were males and 4 patients (11.1%) were females. Extension to the iliac artery existed in 28 patients (77.8%). Thirteen patients (36.1%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $73.7{\pm}13.3$ mm (60 to 100 mm). Surgery was performed by a midline laparotomy and 10 patients (27.8%) underwent emergency surgery. The mortality rate was 8.3%; the mortality rate for the patients with ruptured aneurysms was 23.1 % and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included wound infection (3 cases), sepsis (2 cases), renal failure (2 cases) and pneumonia (1 case). Unstable vital signs, pre-operative transfusion, ruptured aneurysm, emergency surgery, comorbidity (DM and syncope) and complications (sepsis and renal failure) were the statistically significant mortality-related factors (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have high mortality, but the unruptured cases are repaired with relative safety. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, an elective operation of the unruptured aneurysms could decrease the procedure's morbidity and the inconvenient for repeat evaluation with good surgical results.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.964-972
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• 1998

Background: The purpose of this study was to independently evaluate the beneficial effects of a high dose of transamine administrated prior to CPB on the postoperative hematologic aspect and bleeding. Materials and methods: This study included randomly selected groups of 40 adult patients undergoing OHS with CPB. All patients were divided into 2 groups: transamine group (T-group, n=20) and placebo group(P-group, n=20). The T-group received a high-dose of transamine(10 g) before and during CPB. The P-group received normal saline at the same times and served as a control group. Results: The results of comparative studies between the 2 groups in the same hematologic variables were summarized as follows. \circled1 During CPB, the fibrinogen concentrations and platelet counts were significantly lower in the P-group than in the T-group(p<0.01). \circled2 During CPB, production of D-dimer occurred in 18 patients(90%) in the P-group and did not occur in the T-group(0%) (p<0.0001). \circled3 At CPB-off, the % concentration of fibrinogen(70.2$\pm$3.9%) and the % platelet counts(72.4$\pm$4.5%) of the T-group were significantly higher than those(54.5$\pm$3.8%, 64.3$\pm$2.9%) of the P-group(p<0.01). \circled4 Postoperative values of PT(14.0$\pm$0.03 sec.) and aPTT (27.6$\pm$0.1 sec.) of the T-group were significantly lower than those(16.0$\pm$0.02sec., 30.1$\pm$0.1sec.) of the P-group(p<0.05). \circled5 Postoperative bleeding and requirement of whole blood and other blood products were significantly less in the T-group than in the P-group(p <0.05). \circled6 There were no significant hypercoagulability signs such as cerebral em bolism, myocardial infarction, pulmonary embolism, or any other neurological prob lems in either group. Conclusions: We concluded that a high dose of transamine administered prior to CPB prevents the activation of fibri nolytic system and has beneficial effects of reducing the postoperative bleeding t endency without apparent hypercoagulability signs.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.236-241
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• 2003

Purpose : This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. Methods : This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. Results : The mean age of the 19 cases was $4.7{\pm}2.8year$. The male to female ratio was 1 : 1.1. Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. Conclusion : Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.

• Journal of Life Science
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• v.24 no.9
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• pp.1030-1038
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• 2014

Platelet products are used to treat hemorrhagic or platelet dysfunction diseases. Plateletpheresis involves collecting the platelet components of blood using an apheresis blood-collection system. Various indicators are available for evaluating the qualities of the apheresis platelets. The productivity of platelet collection is evaluated through both the collection efficiency and collection rates. Platelet storage quality can be evaluated in vitro using several indicators, including visual appearance, metabolic activities, volume, platelet count, white blood cell count, microparticles, and various platelet activation markers. Platelet activation markers have been used as indicators of storage quality in various studies. Post-transfusion platelet quality can be evaluated based on the corrected count increment and the percentage of platelet recovery. Although various studies have investigated the aspects of plateletpheresis, no article has systemically presented assessments of the platelet products obtained from different plateletpheresis devices. The present study provides a review of plateletpheresis, including the specifics of the process, the types of devices employed, the platelet quality, the overall efficacy, and the evaluation indicator qualities. Furthermore, the differences in functionality among the different apheresis devices are discussed. Although adverse reactions to the citrate anti-coagulant have been reported, apheresis processing may provide a safer option for donors who are at a high risk for presyncopal or syncopal reactions related to whole blood collection.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.466-471
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• 1998

Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.