• 전기학회논문지
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• 제64권8호
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• pp.1251-1255
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• 2015

The purpose of this study is to measurement the cardiac output using hand to hand impedance method to provide convenience to user when measuring SV(stroke volume) with the use of ICG(Impedance Cardiography). We suggest the optimized modified formula, which can be applied when using impedance with the use of hand to hand Impedance. To verify this formula, a SV from transthoracic approach and hand to hand approach are compared for the 36 subjects, respectively. The acquired data was analyzed by using LabVIEW 8.6, analysis was implemented by SPSS 12.0. Fine difference was shown by individual. We showed that as a result of analyzing the ICG measurement value on thoracic and hand to hand, the correlation with SV was r=0.716, thereby having indicated the results of regression model in relatively high correlation.

• 전기의세계
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• 제28권12호
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• pp.27-32
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• 1979

13명의 환자에 있어서 새로운 비관혈적 방법에 의한 심박출량을 계산하고, 열희석에 의한 방법으로 측정한 심박출량과 비교하였다. 본 논문에서 사용한 비관혈적 펄스 전달 방법은 대동맥 모델에서의 최적 매개변수 방법을 사용하였다. 모델의 최적 매개변수는 맥압의 첫번째 고주파 전달함수에서 측정치와 계산치의 차이를 최소화하는 조건에 의하여 계산하였다. 전달함수의 2개의 펄스는 각각 경동맥동과 대퇴동맥에서 Piezo-resistive Pulse Microphone을 사용하여 측정하였고, 대동맥의 직경은 초음파 방법을 사용하여 측정하였다. 13명의 환자에게서 16가지 측정을 해서 열희석과 비관혈적 방법은 0.89의 상관계수를 보여주었다.

• Journal of Chest Surgery
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• 제18권4호
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• pp.598-604
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• 1985

One hundred consecutive patients with the Tetralogy of Fallot underwent total correction at National Medical Center during the period 1977 to 1984, Oct. During this study period, we adopted more active policy towards reconstruction of right ventricular outflow tract across pulmonary valve. The mortality was 48% for patients less than 15 kg and 19% in patients above 15kg. Initially Bretschneider`s solution was used as cardioplegia, which was replaced by St. Thomas` solution since 1983, Jan. After then overall mortality dropped to 9% compared to 45% of initial learning period. Heart block occurred In 11 patients, 10 of whom died of combined low cardiac output syndrome. Pure low cardiac output syndrome was noted in 18 patients, most of whom responded to medical measures well except 4 patients. Recently sepsis of Serratia marcescence, which occurred explosively during several months to open heart surgery patients, attacked 3 tetralogy patients resulting in 2 hospital deaths. Our experience has shown that body weight, choice of cardioplegia and accumulation of experience as well as advance of operative and postoperative techniques are still important factors affecting survival rate at initial learning period.

• 대한의생명과학회지
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• 제12권3호
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• pp.289-301
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• 2006

Cardiopulmonary bypass (CPB) for cardiac surgery triggers the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that leads to postoperative major organ dysfunction. Traditionally, corticosteroids (steroid) have been administered to patients undergoing cardiac surgery to ward off these detrimental physiologic alterations. However, the majority of the studies have been performed on adult patients with high-dose steroid. We carried out a randomized, prospective, double-blind study to compare the efficacy of low-dose steroid with that of high-dose steroid and to determine the adequate dose of pretreated-steroid for prophylactic effects in pediatric cardiac surgery. Thirty pediatric patients scheduled for elective cardiac surgery were randomly assigned to two groups; fifteen patients received low-dose methylprednisolone (10mg/kg intravenously, n=15, low-dose group) and the others received high-dose methylprednisolone (30mg/kg intravenously, n=15, high-dose group) 1 hour prior to CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after start of CPB (CPB-10), and immediately after CPB-end (CPB-OFF) for measuring total leukocyte counts (T-WBC) and diff-counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), total antioxidant (TAO), neuron-specific enolase (NSE), troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and blood urea nitrogen (BUN) levels. Other parameters such as volumes of urine output, pulmonary index $(PI,\;PaO_2/FiO_2)$, mechanical ventilating period, intensive care unit (ICU)-staying period, postoperative complications (fever, wound problem), postoperative 24 hrs and total volumes in blood loss, and hospitalized days were also assessed. All parameters were compared between two groups. There were no significant differences in T-WBC counts, monocyte fraction, platelet counts, TA levels, NSE levels, creatinine levels, BUN levels, the volumes of total urine output, PI, the incidences of fever and wound problem, postoperative 24hrs- and total-blood loss volumes and ICU-staying period between two groups (P>0.05). At CPB-OFF, neutrophil fraction, MPO level, TNI level, and AST level were higher in the high-dose group than in the low-dose group (P<0.05). IL-6 level at CPB-10 was higher in the high dose-group than in the low-dose group (P<0.05). Furthermore, mechanical ventilating periods and hospitalized days of the high-dose group were significantly longer than those of low-dose group (P<0.05). The high-dose group had significantly low lymphocyte fi-action at CPB-OFF compared with the low-dose group (P<0.001). These findings suggest that pretreatment of high-dose steroid is not superior to that of low-dose steroid regrading its potential benefits in pediatric cardiac surgery. Therefore, the conventional strategy of steroid treatment, high-dose pretreatment, should be modified in the cardiac surgery with CPB. However, further studies must be performed on the larger number of patients in as much as small number of patients in this study.

• Journal of Chest Surgery
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• 제33권1호
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• pp.1-6
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• 2000

Background: TNF-$\alpha$ plays a major role in producing left ventricular dysfunction cardio-myopathy pulmonary edema and inhibits the compensatory mechanism of congestive heart failure. IL-6 is an acute reactant of immune reaction and also known to control immune reaction but its function in the myocyte was not clearly investigated. Author's performed this experiment to investigate the contents of TNF-$\alpha$ and IL-6 on the assumption that TNF-$\alpha$ and IL-6 may reside in nonfailing heart that has gone cardiac surgery and play some role in cardiac function. Material and Method : Right auricular tissues were sampled from 12 patients who had undergone total corrective surgery for both congenital and acquired heart diseases from January 1998 to June 1998 in Kosin Universcfy Gospel hospital. The quantitive analysis of TNF-$\alpha$ and IL-6 were assessed by ELISA method in right auricular tissue. Hemodynamic values about the pressure of ventricle atrium aorta pulmonary artery and cardiac index pulmonary and systemic vascular resistance and cardiac output were measured by echocardiography and cardiac catheterization and biochemical analyses of LDH & AST were done before operation. statistical analysis was by Paired Student t-test. Patients were divided into children(under 15 years olds) and adults groups and the data was compared beween two groups. Conclusion: Mild pulmonary hypertension and increased pulmonary vascular resistance were existed in both group. The contents of tissue TNF-$\alpha$ IL-6 in each group were independent of each data.

• 대한의용생체공학회:의공학회지
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• 제14권1호
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• pp.41-50
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• 1993

This paper proposes an adaptive technique for the cardiac output regulation of a pendulum type electromechanical TAH. This techinque, which consists of two RLSE's and two PASTC' 5, performs Its controllability over the TAIB so that the m(RAP) and m(LAP) values re- main close to their desired values under she assumption that the variation of m(RAP) and m (LAP) are dominated by the variation of C.0. and the difference between the left and right ventricular output, respectively. To evaluate the performance of the proposed control system, a simulation is performed by using a human model which contains physiologic, drug and treatment, artificial heart and noise models. As a result, dual adaptive controller showed that abnormal m(LAP) and m(RAP) could be recovered to the normal range within 10minute and maintained desired value in steady state. The operation of this controller prored to be robust in spite of the rapid variation of human status.

• Journal of Chest Surgery
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• 제43권6호
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• pp.769-773
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• 2010

전신저혈압은 흉부대동맥질환의 스텐트 그라프트 치료에 전통적으로 많이 이용되어 왔으나, 혈관확장제를 이용한 혈압강하는 심박출량을 증가시킬 수 있으며 이로 인해 스텐트 그라프트의 전개 시 바람자루효과가 발생할 수 있다. 빠른 심실유도는 자동제어방식으로 일시적인 심박출량의 정지를 유도하여 심정지 지속시간이 제어 가능하고, 스텐트 그라프트 전개 시 대동맥 손상을 최소한으로 줄일 수 있다는 장점이 있다. 본원에서는 흉부대동맥궁 하방에 발생한 주머니동백자루 환자에게 빠른 심실유도하에 Valiant Captivia 스텐트 그라프트를 이용하여 효과적으로 혈관내 스텐트 그라프트 시술을 하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.183-190
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• 2015

Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.

• Archives of Pharmacal Research
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• 제29권9호
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• pp.777-785
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• 2006

Nelumbinis Semen (NS), or lotus seed, is one of the most well-known traditional herbal medicines and is frequently used to treat cardiovascular symptoms in Korea. The anti-ischemic effects of NS on ischemia-induced isolated rat heart were investigated through analyses of changes in blood pressure, aortic flow, coronary flow, and cardiac output. The subjects in this study were divided into two groups: a control, untreated ischemia-induced group, and an ischemia-induced group treated with NS. There were no significant differences in perfusion pressure, aortic flow, coronary flow and cardiac output between the groups before ischemia was induced. The supply of oxygen and buffer was stopped for ten minutes to induce ischemia in isolated rat hearts, and NS was administered during ischemia induction. NS treatment significantly prevented decreases in perfusion pressure, aortic flow, coronary flow and cardiac output under ischemic conditions (p<0.01). In addition, the mechanism of the anti-ischemic effects of NS was also examined through quantitation of intracellular calcium content in rat neonatal cardiomyocytes. NS significantly prevented intracellular calcium increases induced by isoproterenol (p<0.01). These results suggest that NS has distinct anti-ischemic effects through calcium antagonism.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2000년도 추계학술대회논문집B
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• pp.371-376
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• 2000

In this study, the computational method is presented to simulate the hemodynamics of the patients after the Fontan procedure. The short-term feedback control models are implemented to assess the hemodynamic responses of the patients exposed to the stresses such as gravitational effect or hemorrhage. To construct the base line of the Fontan model, we assume an increase in venous tone, in heart rates, and in systemic resistance that are based on the clinical observations. For the verification of the present method we simulate the LBNP (lower body negative pressure) test for the normal and the Fontan model and we compare these with experimental data. Computational results show that the diastolic ABP(arterial blood pressure) increases but the systolic ABP decreases during LBNP. The increase in heart rate is due to the control system activated by the decreased mean ABP and CVP(central venous pressure). In case of the Fontan model, the increased venous tone is the reason of the diminished CVP change during LBNP. We also simulate 20% hemorrhage stress to the patient after the Fontan procedure and these results are compared with the experimental and the existing computational one. Computational results on the hemodynamics of patients after the Fontan procedure show that the mean ABP and cardiac output decrease. Heart rate and systemic resistance increase to compensate for the decrease in ABP. The sensitivity analysis according to the conduit resistance is also presented to delineate the effects of the local blood flow resistance. The cardiac output decreases according to the increase of the conduit resistance. The 50% increase in the conduit resistance causes about 3% decrease of cardiac output.