• Journal of Chest Surgery
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• v.28 no.5
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• pp.491-494
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• 1995

A fibroma arising in the right ventricle outflow tract of a 14 month-old infant was successfully removed. The patient was first seen because of shortness of breath and tachycardia. Pertinent clinical and laboratory findings included a grade II/VI systolic murmur, blood pressure of 120/60 mmHg, slight cardiomegaly on chest X-ray, a mass obstructing the outflow tract of the right ventricle on echocardiography and magnetic resonance imaging. On october 30,1992, under cardiopulmonary bypass, a 4cm x 3cm x 3cm tumor was resected from the right ventricular outflow tract, together with a portion of the ventricular wall. Histologically, it was diagnosis as a fibroma. The patient was sent home on the 6th postoperative day following an uneventful recovery form the operation. Although cardiac fibroma is the second most common cardiac tumor in infancy and childhood, it is usually found in the left ventricle and one arising in the right ventricle is considered rare. Although it is a benign tumor, it could produce a severe cardiac dysfunction and even sudden death, depending on its size and location. With the advance in diagnostic techniques and operative management, there is a renewed interest in the early detection and operative removal of these tumors. The case herein presented is the first such case successfully managed and reported in the Korean literature.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.563-570
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• 1994

Effect of ischemic preconditioning on left ventricular function after cardiac arrest in isolated rat heart.Ischemic preconditioning reduces infarct size caused by sustained ischemia. However, the effects of preconditioning on post ischemic cardiac function are not well-known. The objective of the present study was to determine whether preconditioning would improve the recovery of left ventricular functions after cardiac arrest in isolated rat heart model.Isolated rat hearts were allowed to equilibrate for 20 minutes and were then subjected to either 5 minutes of global, normothermic transient ischemia [Group 2 and 4] or not [Group 3]. A stabilization period of perfusion lasting 5 minutes after the termination of transient ischemia was followed by a standard global, normothermic 20 minute-ischemia and 35-minute reperfusion challenge [Group 3 and 4]. These following results were odtained.1. The recovery of left ventricular developed pressures showed no significant differences between Group 3 and Group 4 at 50 [P>0.3] and 85 minute [P>0.2].2. Heart rates showed no significant differences throughout all the course of experiment and between groups [P>0.5].3. The recovery of left ventricular maximum dP/dt showed no significant differences between Group 3 and Group 4 at 50 [P>0.1] and 85 minute [P>0.2].4. The recovery of pressure-rate products showed no significant differences between Group3 and Group 4 at 50 [P>0.5] and 85 minute [P>0.1].These results suggest that ischemic preconditioning does not provide significant benefit for the postischemic left ventricular functions in isolated rat hearts.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.226-229
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• 2006

Recently, heart transplantation has been accepted as a standard treatment for infant and children with end-stage cardiomyopathy or complex congenital heart disease. Due to the shortage of donors, size-mismatched cardiac transplantation is common. After size-mismatched transplantation, there could be side-effects such as hypertension and hypertensive encephalopathy because of the big-heart. Donor heart is also known to do remodel as time goes by. This is a case report of a size-mismatched heart transplantation between 9-year-old boy and a 39-year-old female whose body weight is almost twice of him. In this case, classical postoperative hypertension and hypertensive encephalopathy developed but was successfully managed. The donor heart has remodeled to normal dimension during 3 years follow-up period.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.207-211
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• 2000

Backgroud: Conventional cardiac transplantation with each atrial anastomosis designed by Shumway and associates has been used widely in cardiac transplantation because of its simplicity and efficiency. There have been many reports about the postoperative atrioventricular value regurgitation resulting from the alteration in atrial geometry after cardiac transplantation by Shumway's technique. New surgical technique of direct anastomosis of superior vena cava, inferior vena cava, right pulmonary vein and left pulmonary vein was introduced to overcome the those problems. We performed this study to test the feasibility of this new surgical technique prior to application to clinical practice. Material and Method: Conventional cardiac transplantation was performed on 12 mongrel dogs(Group I) and cardiac transplantation with new surgical mthod of direct anastomosis of SVC, IVC, left and right pulmonary veins was performed on 11 mongrel dogs(Group II). After weaning from cardiopulmonary bypass, we compared the postoperative rhythm, hemodynamic data, and echocardiographic findings between two groups. Result : The cardiopulmonary bypass time and graft ischemic time were 119.0$\pm$4.4 minutes, 162.0$\pm$4.5 minutes respectively in group I, and 140.0$\pm$7.1 minutes, 180.5$\pm$5.4 minutes respectively in group II. The cardiopulmonary time and graft ischemic time in group II were longer than those of group I (p<0.05). There were 3 cases of failure to weaning from cardipulmonary bypass onein group I and two in group II, and this difference was not significant statistically. Sinus rhythm was regained postoperatively in 58% (group I) and 82%(group II), without statistical significant between 2 groups. Postoperative echolcardiography showed 2 cases of tricuspid value regurgitation and 1 case of mitral regurgitation in group I, and no regurgitation of atrioventricular value in group II. Conclusion: Although these was no statistically significant difference between 2 groups, there was tendency of less arrhythmia and less atrioventricular valvular regurgitation in group II. We suggested that the new surgical technique could be a useful strategy in heart transplantation, especially in the case of size mismatching between donor and recipient.

• Proceedings of the KAIS Fall Conference
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• 2011.12a
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• pp.170-173
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• 2011

Therapeutic hypothermia(TH) improves neurological outcomes and reduces mortality among survivors of out-of-hospital cardiac arrest. Animal and human studies have shown that TH results in improved salvage of the myocardium, reduced infarct size, reduced left ventricular remodeling and better long-term left ventricular function in settings of regional myocardial ischemia. This study is to investigate the effect of TH on post-resuscitation myocardial dysfunction and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction (MI). Thoracotomies were performed in 10 Male Sprague-Dawley rats weighing 450-550 g. MI was induced by ligation of the left anterior descending coronary artery (LAD). Ninety min after LAD ligation, ventricular fibrillation induction and subsequent cardiopulmonary resuscitation was performed before defibrillation attempts. Animals were randomized to two groups: a) Acute MI-Normothermia b) Acute MI-Hypothermia ($32^{\circ}C$ for 4 h). Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured echocardiographically together with duration of survival. Ejection fraction, cardiac output and myocardial performance index were $54.74{\pm}9.16$, $89.00{\pm}8.89$, $1.30{\pm}0.09$ respectively and significantly better in the TH group than those of the normothermic group at the first 4 h after resuscitation($32.20{\pm}1.85$,$41.60{\pm}8.62$,$1.77{\pm}0.19$)(p=0.00). The survival time of the hypothermic group ($31.8{\pm}14.8$ h) was greater than that of the normothermic group($12.3{\pm}6.5$ h, p<0.05). This study suggested that TH attenuated post resuscitation myocardial dysfunction in acute MI and would be a potential strategy in post resuscitation care.

• Journal of radiological science and technology
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• v.41 no.6
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• pp.545-552
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• 2018

The purpose of this study was evaluated the relationship between echocardiography and cardiac computed tomography in normal adults by visual assessment, and evaluated the effective doses of cardiac computed tomography. The subjects were 100 normal patients who visited two general hospitals in Chungnam, from January 1 to May 30, 2018. We obtained images by using these modalities and evaluated the wall thickness and internal dimension of the Left Ventricle with visual assessment. To evaluate the appropriateness of the visual evaluation, two evaluators who were trained for one week were measured and the agreement between the evaluators were verified by statistical analysis. The effective doses of computed tomography were evaluated using the dose length product. As a result, there was a high correlation between the two modalities. The agreement between the two visual evaluator were also highly agreed. The mean X-ray dose of the subjects was $11.1{\pm}3.1mSv$. Although the purpose of imaging is somewhat different in the clinical setting, echocardiography could achieve the same results as radiation-invasive computed tomography. It is thought that utilization will become even larger.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.402-408
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• 1982

The primary cardiac tumor was considered as a form of disease with poor prognosis in the past and it was hardly diagnosed before post mortem autopsy. But recent development of diagnostic procedure and the cardiac surgery using extracorporeal circulation increased the accuracy of diagnosis and the opportunity of successful treatment. The authors present two cases of left atrial myxoma which experienced during recent 4 years between 1979 and 1982. A 33 year old woman admitted with severe shortness of breath, generalized edema, ascites and the evidence of hepatopathy resulted from right sided heart failure. Preoperatively, the patient was treated with conservative medication to improve general condition for a few days. The tumor mass was removed successfully under the cardiopulmonary bypass. She, however, died of myocardial dysfunction showing low blood pressure. The tumor mass weighed 22gm and measured 5.2x4.5x3.6 cm in size. A 60 year old man admitted with shortness of breath on exertion and an episode of fainting. Following the removal of tumor mass under the cardiovascular bypass, the clinical course was satisfactory with no complication. The tumor mass weighed 105gm and measured 9x4x5 cm in size.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.157-164
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• 1985

Our series comprised 68 patients of ventricular septal defect who underwent open heart surgery at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from January, 1980 to September, 1984. Of the 68 patients, 47 patients were male [69.1%] and 21 patients were female [30.9%]. Their age ranged from 3 years to 27 years, and the mean age was 10.1 years. Upon Kirklin`s anatomical classification, type I constituted 29.4%, type II 69.1%, type III 1.5%, and type IV 1%. The cardiac anomalies associated with ventricular septal defect were 21 in all; 5 PS, 4 Aortic insufficiency, 2 ASD, 4 Patent foramen ovale, and 1 Patent ductus arteriosus. Upon the data of cardiac catheterization, most of the patients had Qp/Qs of 1.4-1.8, Pp/Ps of 0.25 or less and Rp/Rs of 0.25 or less. There was no significant correlationship between the rate of operative complication & mortality and the increase of Qp/Qs, Pp/Ps, and Rp/Rs. The values of Qp/Qs, Pp/Ps and Rp/Rs were correspondingly increased according to increment of the defect size. 20 patients developed postoperative complications, such as 4 acute respiratory failure, 3 reexploration due to massive bleeding, 1 low cardiac output, 1 patch detachment, and 2 air embolism. Operative mortality rate was 7.4% [5 cases] among 68 patients.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.735-738
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• 1998

Intracardiac hemangiomas are very rare primary cardiac tumor and there have been at least 37 reports of surgically resected cardiac hemangiomas. Most cardiac hemangiomas are asymptomatic. In symptomatic patients, symptoms are related to the location of tumor and outflow tract obstruction or obstruction of inferior and/or superior vena cava. Sudden death may occur due to conduction disturbances. The principle of treatment is surgical resection, and the prognosis is dependent upon the size, location and multiplicity of the tumor. A 40 year old man was admitted due to chest contusion and was found to have an intracardiac mass during echocardiographic examination. The mass was successfully removed and pathologic examination showed benign hemangioma. The patient was recovered uneventfully in postoperative period and was followed up for 1 year without evidence of recurrence.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2009.05a
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• pp.337-340
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• 2009

Wireless tele-home-care application gives new possibilities for ECG (electrocardiogram) monitoring system with wearable biomedical sensors. Thus, continuously development of high convenient ECG monitoring system for high-risk cardiac patients is essential. This paper describes to monitor a person's ECG using wearable approach. A wearable belt-type ECG electrode with integrated electronics has been developed and has proven long-term robustness and monitoring of all electrical components. The measured ECG signal is transmitted via an ultra low power consumption wireless sensor node. ECG signals carry a lot clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed thus it bring errors due to motion artifacts and signal size changes. Variable threshold method is used to detect the R-peak which is more accurate and efficient. In order to evaluate the performance analysis, R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research. This concept able to allow patient to follow up critical patients from their home and early detecting rarely occurrences of cardiac arrhythmia.