• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.208-213
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• 2002

Purpose : The major cause of cardiac dysfunction, after open heart surgery for congenital heart disease, is perioperative myocardial injury. Cardiac troponin I is found only within the myocardial cell, so it can be used as a biochemical marker of the myocardial injury. We performed this study to evaluate the worth of cardiac troponin I as a biochemical marker reflecting the extent of perioperative myocardial injury and recovery. Methods : Thirty-four patients who had undergone elective open heart surgery of congenital heart disease(CHD) from April to July 2001 were enrolled in this study. We measured types of CHD, serial cardiac troponin I(baseline 1 day before operation, postoperative day 1, 2, 3, 7), duration of cardiopulmonary bypass(CPB), aortic cross clamping(ACC), intubation and postoperative hospital stay. Results : Compared with the baseline before operation, there was a significant, increase of cardiac troponin I on the postoperative day 1 and a significant gradual decrease on the day 2, 3, 7. The levels of cardiac troponin I were the highest in the transposition of great artery(TGA) repair on the postoperative day 1 and high in the tetralogy of Fallot(TOF), atioventricular septal defect (AVSD), ventricular septal defect(VSD) and atrial septal defect(ASD) repair with decreasing sequence. The longer duration of CPB, ACC and intubation, the higher of cardiac troponin I, but there were no significant correlations between cardiac troponin I levels and duration of hospital stay. Conclusion : Because there was significant increases or decreases of cardiac troponin I according to the perioperative time and types of the congenital heart disease, it is a worthy biochemical marker which reflects the extent of perioperative myocardial injury and recovery after open heart surgery.

• Journal of Life Science
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• v.17 no.4 s.84
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• pp.515-521
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• 2007

Aprotinin, a serine protease inhibitor, has been used to ameliorate the inevitable consequences, including blood component injury after cardiac surgery with cardiopulmonary bypass (CPB). However, there are many arguments on its dosage or usage. We assessed whether administration of low dose of aprotinin in only priming solution has any beneficial effect or reduces its side effects on cardiac surgery. Thirty patients scheduled for elective cardiac surgery were randomly assigned to aprotinin group (n=15) which received aprotinin in priming solution (two million kallikrein inhibitory unit, KIU) and added one million KIU at 1 hour after the beginning of CPB or control group (n=15) which did not receive it. Hematological and biochemical variables, cytokines and cardiac marker levels, and postoperative outcomes were compared between two groups at before, during or after operation. Platelet count in aprotinin group was higher than that of control group at postoperative 24 hr. Activated partial thromboplastin time in aprotinin group was longer than that of control group at intensive care unit (ICU). Troponin-I level and postoperative blood loss volumes in aprotinin group were lower than those of control group at ICU. There were no significant differences between the two groups on the others. These results showed that low dosage of only priming solution during cardiac surgery with CPB reduced platelet destruction and postoperative bleeding, and attenuates myocardial damage. However, further studies need to be carried out with more population or pediatric patients for evaluating various aprotinin usage.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1092-1096
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• 1997

Thromboelastography(TEG) enables a global assessment of hemostatic function to be made from a single blood sample, documenting the interaction of platelets with protein coagulation cascade from the time of the initial platelet-fibrin interaction, through platelet aggregation, clot strengthening and fibrin cross linking to eventual clot Iysis. Thirty-five patients(mean age 34$\pm$ 12) undergoing open heart surgery from April 1st, 1996 to August 31th, 1996 were investigated at preoperatively and immediate, one hour, and 24 hours after cessation of cardiopulmonary bypass using TEG. Comparisons were made between classic hematological indices and TEG data. There were statistically significant correlation between maximal amplitude(MA) and platelet count before CPB, activating clotting time(ACT) and TEG date(R time, K time and a angle) at 24-hour after CPB. The data on the predictive accuracy for postoperative bleeding at 24-hour after CPB, the TEG was significantly better than ACT(57%) or the coagulation profiles(43%) as a predictor of postoperative bleeding, with an accuracy rate of 100% (P=0.0043). In conclusion, TEG seems to be easy to use, clinically accurate, cost effective and provides data which can effectively manage a patient's hemostasis.

• The Korean Journal of Mycology
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• v.24 no.2 s.77
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• pp.93-103
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• 1996

In order to find out effect on the inorganic and organic compounds as a soil amendment to control Fusarium wilt of cucumber caused by Fusarium oxysporum f. sp. cucumerinum, this study was conducted during the last two years from 1993 to 1995. According to add 14 inorganic chemicals (1%, w/v) including $Al_2(SO_4)_3$ individually in vitro, these chemicals were confirmed their suppression, and especially Alum, CaO and $Al_2(SO_4)_3$ suppressed not only $20.9{\sim}25.0$ percent on mycelial growth of the fungus, but also inhibited $72.8{\sim}97%$ on conidial germination. $Ca(NO_3)_2$ suppressed mycelial growth only, while KCl, $K_2SO_4,\;NH_4NO_3$, and Urea suppressed conidial germination. The 7 chemicals were finally seleced. Composted pine bark (CPB) suppressed definely more than 90% on conidial germination in the different extract concentration (2,5 and 10%), although mycelial growth on extract medium of CPB and milled alfalfa leaves (MAL) were not remarkable. The antagonist Trichoderma sp. (Tr-3) mixed with an amended soil (1%, w/w) containing composted pine bark showed a good mycelial growth to compete the causal fungus. And the antagonist Pseudomonas sp. (7-1-3) was also confirmed its antagonistic ability with culture filterate. It is known that a CPB soil amendment mixed with the two antagonists (1%, w/w) controlled almost completely Fusarium wilt of cucumber in greenhouse pots and a field experiment. It is therefore expected that biocontrol on Fusarium wilt of cucumber by a soil amendment can be applied to farmmer's fields.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.99-113
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• 1994

Pentastarch is a new synthetic hydroxyethyl starch similar to hetastarch. We report on the clinical comparisons the clinical efficacy and safety of 10% pentastarch in prime solutions for CPB in cardiac operations with that of 20% serum albumin. During CPB, group P [n = 20] received 500ml of 10% pentastarch and group A [n = 20] received 100ml of 20% albumin in prime solutions The postoperative time of ICU stay in group P and the day and amount of chest drain, hospital stay in group A were longer [p<0.05]. Fresh whole blood and PRBC were added only in group A and a higher amount of hartman solution was added in group A during CPB [p<0.05]. Prothrombin time was prolonged preoperatively and 2 days postoperatively in group A and 7 days postoperatively in group P [p<0.05] but there were no significant differences in bleeding time or fibrinogen level. Platelet count was higher immediately postoperatively in group A and preoperatively and 1, 2, and 7 days postoperatively in group P [p<0.05].Total protein and albumin level were higher 1 day postoperatively in group A and 2 and 7 days postoperatively in group P [p<0.05]. BUN was increased 2 days postoperatively in group A and Cr was increased 1 day postoperatively in group P [p<0.05]. CPK was higher preoperatively and 1, 2, and 7 days postoperatively in group A and plasma hemoglobin level was also higher 2 and 7 days postoperatively in group A [p<0.05]. There were no significant differences in arterial blood gas analysis but higher pO2 and lower pCO2 levels were maintained in group P and ejection fraction was higher 7 days postoperatively in group P [p<0.05]. Both groups were improved postoperatively in NYHA class and the hemodynamic parameters such as MAP, CO, CI, SV, LVSWI were well maintained in group P [p<0.05]. The amount of blood products used was higher in group A and urine output was higher immediately postoperatively in group A and 1, 2 days postoperatively in group P and the chest output was higher in group A. The complications were developed in 7 patients in group A and 5 patients in group P and mortality was not present in both groups.In conclusion, 10% pentastarch is as safe and effective as 20% albumin in prime solutions for cardiopulmonary bypass in cardiac operations.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.255-261
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• 2014

Background: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair. Methods: We identified 103 patients (23 females; mean age, $64.1{\pm}12.3$ years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%). Results: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was $80.9%{\pm}4.3%$ and $71.7%{\pm}5.9%$, respectively. Reoperation-free survival at 5 and 10 years was $77.3%{\pm}4.8%$ and $70.2%{\pm}5.8%$. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p<0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p<0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49). Conclusion: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.

• Journal of Biomedical Engineering Research
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• v.40 no.5
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• pp.197-205
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• 2019

The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

• Proceedings of the Korean Society of Dyers and Finishers Conference
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• 2003.08a
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• pp.95-135
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• 2003

섬유제품 중 의류용으로 소비자들이 가장 많이 선호하는 것은 면 섬유이고, 그 중 니트제품이 차지하는 비율은 약 절반 정도이다. 면 섬유가 갖는 여러 가지 장점들을 대체하기 위하여 여러 가지 합성섬유가 개발되었으나, 천연섬유에 대한 소비자 인식이 높아지면서 스판덱스와 같은 탄성섬유를 제외한 합성섬유 소비는 점차 줄어들고 있는 반면, 면 섬유와 천연 원료에서 추출하는 모달, 텐셀, 라이오셀 등의 셀룰로오스계 신 소재는 그 소비가 증가하고 있는 추세이다. (중략)

• Proceedings of the Korean Society of Dyers and Finishers Conference
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• 2002.08a
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• pp.71-116
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• 2002

섬유제품 중 의류용으로 소비자들이 가장 많이 선호하는 것은 면 섬유이고, 그중 니트제품이 차지하는 비율은 약 절반 정도이다. 면 섬유가 갖는 여러 가지 장점들을 대체하기 위하여 여러 가지 합성섬유가 개발되었으나, 천연섬유에 대한 소비자 인식이 높아지면서 스판덱스와 같은 탄성섬유를 제외한 합성섬유 소비는 점차 줄어들고 있는 반면, 면 섬유와 천연 원료에서 추출하는 모달, 텐셀, 라이오셀 등의 셀룰로오스계 신 소재는 그 소비가 증가하고 있는 추세이다. (중략)

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.