• Journal of Biomedical Engineering Research
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• v.36 no.5
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• pp.198-203
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• 2015

The purpose of the study is to examine the effects of pacemaker location on cardiac pumping efficacy theoretically. We used a three-dimensional finite element cardiac electromechanical model of canine ventricles with models of the circulatory system. Electrical activation time for normal sinus rhythm and artificial pacing in apex, left ventricular free wall, and right ventricular free wall were obtained from electrophysiological model. We applied the electrical activation time maps to the mechanical contraction model and obtained cardiac mechanical responses such as myocardial contractile ATP consumption, stroke work, stroke volume, ejection fraction, and etc. Among three artificial pacing methods, left ventricle pacing showed best performance in ventricular pumping efficacy.

• Journal of Biomedical Engineering Research
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• v.9 no.1
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• pp.109-116
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• 1988

In this paper, principles of impedance tenchinque and relationship between stroke volume and impedance change were theoretically explained. An impedance cardiograph was designed and constructed. Its reproducibility was verified by experiment. Until now, the peak point of dZ/dt waveform, first derivative of impedance change(${\Delta}$Z) , has been detected by software technique requiring considerable time to process. However in this paper its peak point was found using hardware for saving processing time. Useful cardiac parameters such as stroke volume and contractility of cardiac muscle were measured noninvasively. The reproducibility of the instrument was measured to be better(less than 10%) than that of clinical standard method such as thermodilution (more than 30%). Hence impedance cardiography was found to be better techique for monitoring stroke volume and myocardial contractility for pre and post operation, and pharmacological studies.

• The Korean Journal of Physiology
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• v.24 no.2
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• pp.249-260
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• 1990

Maximal cardiac output and oxygen uptake $(VO_{2max})$ were measured during treadmill exercise for seven top-class marathoners and nine non-athletes using impedance cardiograph developed by one of the authors (DW Kim). Results of this study are summarized as belows. 1) New shoes with sponge and silicon rubber attached to the soles were developed to reduce motion artifact during treadmill exercise. Ensemble everaging techneque with the developed shoes was also used to improve the measurement of stroke volume using impedance cardiography. 2) Maximal cardiac output of the athletes, 14.98 L/min, was significantly higher than that of the non-athletes, 13.46 L/min. As maximal heart rate of the marathoners is lower than that of non-athletes, stroke volume of the former is significantly larger than that of the latter. 3) $VO_{2max}$ of the marathoners, 59.38 ml/kg/min, was higher than that of the non-athletes, 40.22 ml/kg/min. At the anaerobic threshold. $VO_{2max}$ of the former was 62.3% of $VO_{2max}$ and this was significantly higher than that of the non-athletes, 57.2%, This results indicates that the marathoners have higher aerobic capacity than the non-athletes. 4) The marathoners showed larger $VO_2$ than the non-athletes at the same cardiac output, indicating that a-v $O_2$ of the former is higher than that of the latter. 5) Maximal systolic pressure of the marathoners was higher than that of the non-athletes, and so was maximal rate-pressure products. These results indicate that heart oxygen consumption rate $(hVO_2)$ of the marathoner is higher than that of the non-athletes is mainly due to higher stroke volume. And higher oxygen consumption of the marathoners is due to higher stroke volume. And higher oxygen consumption of the marathoners is due to their larger a-v $O_2$. The marathoners show both higher threshold and $VO_{2max}$. Especially, measurement of cardiac output during treadmill exercise by improved impedance cardiography is expected to contribute in study of cardiac function of athletes.

• Korean Journal of Radiology
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• v.20 no.6
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• pp.956-966
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• 2019

Objective: To characterize the changes in right ventricular (RV) volume, volume load, and function measured with cardiac computed tomography (CT) over the entire time course of tetralogy of Fallot (TOF). Materials and Methods: In 374 patients with TOF, the ventricular volume, ventricular function, and RV volume load were measured with cardiac CT preoperatively (stage 1), after palliative operation (stage 2), after total surgical repair (stage 3), or after pulmonary valve replacement (PVR) (stage 4). The CT-measured variables were compared among the four stages. After total surgical repair, the postoperative duration (POD) and the CT-measured variables were correlated with each other. In addition, the demographic and CT-measured variables in the early postoperative groups were compared with those in the late postoperative and the preoperative group. Results: Significantly different CT-based measures were found between stages 1 and 3 (indexed RV end-diastolic volume [EDV], 63.6 ± 15.2 mL/m² vs. 147.0 ± 38.5 mL/m² and indexed stroke volume (SV) difference, 7.7 ± 10.3 mL/m² vs. 32.2 ± 16.4 mL/m²; p < 0.001), and between stages 2 and 3 (indexed RV EDV, 72.4 ± 19.7 mL/m² vs. 147.0 ± 38.5 mL/m² and indexed SV difference, 5.7 ± 13.1 mL/m² vs. 32.2 ± 16.4 mL/m²; p < 0.001). After PVR, the effect of RV volume load (i.e., indexed SV difference) was reduced from 32.2 mL/m² to 1.7 mL/m². Positive (0.2 to 0.8) or negative (-0.2 to -0.4) correlations were found among the CT-based measures except between the RV ejection fraction (EF) and the RV volume load parameters. With increasing POD, an early rapid increase was followed by a slow increase and a plateau in the indexed ventricular volumes and the RV volume load parameters. Compared with the preoperative data, larger ventricular volumes and lower EFs were observed in the early postoperative period. Conclusion: Cardiac CT can be used to characterize RV volume, volume load, and function over the entire time course of TOF.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.238-241
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• 2017

Background: We investigated the difference in right ventricle (RV) volume and ejection fraction (EF) according to the pulmonary valve (PV) annular extension technique during Tetralogy of Fallot (TOF) total correction. Methods: We divided patients who underwent the procedure from 1993 to 2003 into two groups according to PV extension technique (group I: PV annular extension, group II: no PV annular extension) during TOF total correction. We then analyzed the three segmental (RV inlet, trabecular and outlet) and whole RV volume and EF by cardiac magnetic resonance imaging (MRI). Results: Fourteen patients were included in this study (group I: 10 patients, group II: four patients; male: nine patients, female: five patients). Cardiac MRI was conducted after a 16.1 years TOF total correction follow-up period. There was no statistical difference in RV segmental volume index or EF between groups (all p>0.05). Moreover, the total RV volume index and EF did not differ significantly between groups (all p>0.05). Conclusion: The RV volume and EF of the PV annular extension group did not differ from that of the PV annular extension group. Thus, PV annular preservation technique did not show the surgical advantage compared to PV annular extension technique in this study.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.60 no.9
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• pp.1770-1776
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• 2011

In this study, a new method that can estimate ICG data from a subject's both hands to measure Cardiac Output under convenient sensor environment. With this aim, a grip-type electrode was implemented to measure ICG. To improve the accuracy of measurement, the regression equation was extracted using multiple bio-parameters and our result was compared with the thoracic ICG equipment(Physio Flow$^{(R)}$, PF104D, Manatec Biomedical, France), which is being used in clinics. The subjects consist of 26 men and 4 women(age in $22.0{\pm}3.32$). They are no cardiac disease. Parameters available for regression model were used gender, BMI, MBP, LVET, dZ/dt(max), distance between the measured electrodes, body impedance, and PTT. As a result of analyzing the ICG measurement value on thorax and both hands, the correlation with stroke volume, heart rate, and cardiac output was $R^2$=0.853, $R^2$=0.958 and $R^2$=0.899, respectively.

• The KIPS Transactions:PartB
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• v.15B no.6
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• pp.507-516
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• 2008

Cardiac disease is the leading cause of death in the world. Quantification of cardiac function is performed by manually calculating blood volume and ejection fraction in routine clinical practice, but it requires high computational costs. In this study, an automatic left ventricle (LV) segmentation algorithm using short-axis cine cardiac MRI is presented. We compensate coil sensitivity of magnitude images depending on coil location, classify edge information after extracting edges, and segment LV by applying region-growing segmentation. We design a weighting function for intensity signal and calculate a blood volume of LV considering partial voxel effects. Using cardiac cine SSFP of 38 subjects with Cornell University IRB approval, we compared our algorithm to manual contour tracing and MASS software. Without partial volume effects, we achieved segmentation accuracy of $3.3mL{\pm}5.8$ (standard deviation) and $3.2mL{\pm}4.3$ in diastolic and systolic phases, respectively. With partial volume effects, the accuracy was $19.1mL{\pm}8.8$ and $10.3mL{\pm}6.1$ in diastolic and systolic phases, respectively. Also in ejection fraction, the accuracy was $-1.3%{\pm}2.6$ and $-2.1%{\pm}2.4$ without and with partial volume effects, respectively. Results support that the proposed algorithm is exact and useful for clinical practice.

• Korean Journal of Radiology
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• v.20 no.1
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• pp.114-125
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• 2019

Objective: Segmented cardiac cine magnetic resonance imaging (MRI) is the gold standard for cardiac ventricular volumetric assessment. In patients with difficulty in breath-holding or arrhythmia, this technique may generate images with inadequate quality for diagnosis. Real-time cardiac cine MRI has been developed to address this limitation. We aimed to assess the performance of retrospective electrocardiography-gated real-time cine MRI at 3T for left ventricular (LV) volume and mass measurement. Materials and Methods: Fifty-one patients were consecutively enrolled. A series of short-axis cine images covering the entire left ventricle using both segmented and real-time balanced steady-state free precession cardiac cine MRI were obtained. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and LV mass were measured. The agreement and correlation of the parameters were assessed. Additionally, image quality was evaluated using European CMR Registry (Euro-CMR) score and structure visibility rating. Results: In patients without difficulty in breath-holding or arrhythmia, no significant difference was found in Euro-CMR score between the two techniques (0.3 ± 0.7 vs. 0.3 ± 0.5, p > 0.05). Good agreements and correlations were found between the techniques for measuring EDV, ESV, EF, SV, and LV mass. In patients with difficulty in breath-holding or arrhythmia, segmented cine MRI had a significant higher Euro-CMR score (2.3 ± 1.2 vs. 0.4 ± 0.5, p < 0.001). Conclusion: Real-time cine MRI at 3T allowed the assessment of LV volume with high accuracy and showed a significantly better image quality compared to that of segmented cine MRI in patients with difficulty in breath-holding and arrhythmia.

• Progress in Medical Physics
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• v.10 no.3
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• pp.159-168
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• 1999

Cardiac disease is one of the leading causes of death in Korea. In quantitative analysis of cardiac function and morphological information by three-dimensional reconstruction of magnetic resonance images, left ventricle provides an important role functionally and physiologically. However, existing procedures mostly rely on the extensive human interaction and are seldom evaluated on clinical applications. In this study, we developed a system which could perform automatic extraction of enpicardial and endocardial contour and analysis of cardiac function to evaluate reliability and stability of each system comparing with the result of ARGUS system offered 1.5T Siemens MRI system and manual method performed by clinicians. For various aspects, we investigated reliability of each system by compared with left ventricular contour, end-diastolic volume (EDV), end-systolic volume (ESV), stock volume (SV), ejection fraction (EF), cardiac output (CO) and wall thickness (WT). When comparing with manual method, extracted results of developed process using minimum error threshold (MET) method that automatically extracts contour from cardiac MR images and ARGUS system were demonstrated as successful rate 90% of the contour extraction. When calculating cardiac function parameters using MET and comparing with using correlation coefficients analysis method, the process extracts endocardial and epicardial contour using MET, values from automatic and ARGUS method agreed with manual values within :t 3% average error. It was successfully demonstrated that automatic method using threshold technique could provide high potential for assessing of each parameters with relatively high reliability compared with manual method. In this study, the method developed in this study could reduce processing time compared with ARGUS and manual method due to a simple threshold technique. This method is useful for diagnosis of cardiac disease, simulating physiological function and amount of blood flow of left ventricle. In addition, this method could be valuable in developing automatic systems in order to apply to other deformable image models.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.3
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• pp.730-734
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• 2006

Aqueous extracts of medicinal plants traditionally used in the East Asia such as China, Korea, and Japan were screened for inotropic activity using isolated rabbit atria. Among the twenty-one aqueous-extracts from medicinal plants, the aqueous extracts of Convallaria keiskei(ACK) and rhizome of Coptis chinesis (ACC) were found to exhibit distinctive positive inotropic activity. The aqueous extracts of C. keiskei and rhizome of C. chinensis significantly increased atrial stroke volume and pulse pressure in beating rabbit atria. These findings suggest that the aqueous extracts of C. keiskei and rhizome of C. chinensis enhance the cardiac muscle contractility and then could be useful for the treatment of cardiac failure.