• Journal of Chest Surgery
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• 제25권10호
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• pp.989-1000
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• 1992

The concepts of modern type computer are so called "General purpose, stored program and digital computer" that is proposed by Charles Babbage. ENIAC, the initial operational electronic digital computer model, was produced in 1946. During the last 50 years, an epoch-making development of the personal computer was marked. The computerization of all levels of society is going on and also computerization of the general hospital and medical college is developing. But patient data management system for clinician is not used generally. We suggest the use of computer aided data management application programs for the clinical informations of the patients of the Department of Thoracic and Cardiovascular Surgery for better management and to make best of medical informations, to co-operate with the current of this times, and to prepare against the Hospital Information Systems[HIS], actively. Also, we suggest to standardize the format and structure of database files to store the clinical data of the patients By standardization of the database files, we can integrate and relate the data of the individual department or hospital, build up the regional or national statistics of the patients easily, and promote the generation of application programs. The medical network by the communication and computer would be utilized to collect the database files. And finally, we suggest the use of code system to input and search the informations about the diagnosis and operation such as the code system of International Classfication of Disease[WHO] and the table of the classfication of operation of the Ministry of Health and Social Affairs, Korea. In this article, we tried to show the new standards, the essential items for computerization of clinical informations of the patients of the Department of Thoracic and Cardiovascular Surgery.r Surgery.

• Journal of Chest Surgery
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• 제56권3호
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• pp.179-185
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• 2023

Background: Assessments of air leaks are usually performed subjectively, precluding the use of air leaks as an evaluation factor. We aimed to identify objective parameters as predictive factors for prolonged air leak (PAL) and air leak cessation (ALC) from air flow data produced by a digital drainage system. Methods: Flow data records of 352 patients who underwent lung lobectomy were reviewed, and flow data at designated intervals (1, 2, and 3 hours postoperatively [POH] and 3 times a day thereafter [06:00, 13:00, 19:00]) were extracted. ALC was defined by flow less than 20 mL/min over 12 hours, and PAL was defined as ALC after 5 days. Cumulative incidence curves were obtained using Kaplan-Meier estimates of time to ALC. Cox regression analysis was performed to determine the effects of variables on the rate of ALC. Results: The incidence of PAL was 18.2% (64/352). Receiver operating characteristic curve analysis showed cut-off values of 180 mL/min for the flow at 3 POH and 73.3 mL/min for the flow on postoperative day 1; the sensitivity and specificity of these values were 88.9% and 82.5%, respectively. The rates of ALC by Kaplan-Meier analysis were 56.8% at 48 POH and 65.6% at 72 POH. Multivariate Cox regression analysis revealed that the flow at 3 POH (≤80 mL/min), operation time (≤220 minutes), and right middle lobectomy independently predicted ALC. Conclusion: Air flow measured by a digital drainage system is a useful predictor of PAL and ALC and may help optimize the hospital course.

• Journal of Chest Surgery
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• 제42권2호
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• pp.238-243
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• 2009

배경: 하지 정맥류의 치료에 있어 최소 침습 술기의 발달로 고주파 열폐쇄술이나 혈관 내 레이저)를 이용한 수술이 시행되고 있다. 빠른 시간 내에 효과적으로 혈관을 폐쇄시킬 수 있는 7 Fr. VNUS $ClosureFAST^{(R)}$ 고주파 열폐쇄 System이 국내에 소개되었으며, 본 연구는 이 시스템을 이용한 하지정맥류 치료의 조기 결과를 알아보고자 시행되었다. 대상 및 방법: 2007년 5월 2일부터 2008년 5월 31일까지 고주파 열폐쇄술을 이용하여 수술을 받은 90예의 환자를 대상으로 본 연구를 시행하였다. 남자가 67명(74.4%)이었고 환자들의 평균 연령은 $57.9{\pm}11.0\;(23{\sim}78)$세였다. 수술 후 3주와 이후 3개월 간격으로 혈관 초음파와 임상 양상을 분석하였다. 결과: 수술 후 합병증은 반상 출혈(85예, 94.4%)이 가장 많았으며, 통증을 호소하는 경우가 27.8%, 감각 이상 25.6%, 수포 형성 8.9%, 부종 6.7%, 정맥염 2.2% 등이었다. 술후 3주에 시행한 초음파에서 정맥의 역류나 부분적 혈류 재개가 있었던 환자는 1예로, 치료 성공률은 98.9%였다. 3개월 후 초음파 검사상 혈류 재개가 1예에서 더 관찰되었으며, 이후 3개월 간격으로 시행한 혈관 초음파상 혈류 재개가 관찰되었던 환자는 없었으며, 1년 치료 성공률은 97.6%를 보였다. 혈류 재개를 보였던 2예의 환자는 계속 외래 추적 관찰 중이며, 현재까지는 수술 전 보였던 하지 부종이나 저림 등의 증상을 호소하지 않고 있다. 결론: 저자들은 국내에 처음으로 도입된 7 Fr. VNUS $ClosureFAST^{(R)}$ System을 이용하여 하지 정맥류 수술을 효과적으로 시행하였으며, 고위 결찰이나 기존의 고주파 열폐쇄술, 그리고 혈관내 레이저 치료와 장기적인 비교 분석이 필요할 것으로 사료된다.

• Journal of Chest Surgery
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• 제50권1호
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• pp.8-13
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• 2017

Background: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services. Methods: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015. We retrospectively analyzed the indications for ECMO, the patient status during transport, and the patient outcomes. Results: All transport was conducted on the ground by ambulance. The distances covered ranged from 26 to 408 km (mean, $65.9{\pm}88.1km$) and the average transport time was $56.1{\pm}57.3minutes$ (range, 30 to 280 minutes). All patients were transported without adverse events. After transport, 4 patients (22.2%) underwent lung transplantation because of interstitial lung disease. Eight patients who had severe acute respiratory distress syndrome showed recovery of heart and lung function after ECMO therapy. A total of 13 patients (70.6%) were successfully taken off ECMO, and 11 patients (61.1%) survived. Conclusion: Our ECMO transport system without mechanical ventilation can be considered a safe and useful method for interhospital transport and could be a good alternative option for ECMO transport in Korean hospitals with limited resources.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 추계학술대회
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• pp.74-79
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• 1996

This paper describes a methodology for the development of models of discrete event system(DES). The methodology is based on transformation of continuous state space into discrete one to homomorphically represent dynamics of continuous processes in discrete events. This paper proposes a formal structure which can couple DES models within a framework. The structure employs the DEVS formalism for the DES models. The proposed formal structure has been applied to develop a DEVS model for the human cardiovascular system. For this, the cardiac cycle is partitioned into a set of phases based on events identified through VisSim simulation in the CS of the electrical analog model. VisSim is the simulation tool of visual environment for developing continuous, discrete, and hybrid system models and performing dynamic simulation. For each phase, a CS of the electrical analog model for the cardiovascular system has been simulated by VisSim 2.0. To validate this model, first develop the DEVS model, then simulate the model in the DEVSIM++ environment. It has same simulation results for the data obtained from the CS simulation using VisSim. The comparison shows that the DEVS model represents dynamics of the human heart system at each phase of cardiac cycle.

• 기본간호학회지
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• 제26권3호
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• pp.155-165
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• 2019

Purpose: Although emergency care is one of the most important capabilities for novice nurses, many novice nurses have shown difficulty in emergency care in the clinical field. The purpose of this study was to provide evidence data for the future development of educational programs by analyzing the priorities in emergency care of novice nurses using the Importance-Performance Analysis. Methods: This study was designed as a descriptive survey. The participants were 197 novice nurses who worked in general hospitals from August 1 to 31, 2018. The questionnaire consisted of 'common emergency care', 'cardiovascular emergency care', 'nervous system emergency care', 'respiratory system emergency care', 'communication and teamwork competency'. Results: As a result of this study, 'communication and teamwork' among emergency cares was evaluated as the most important capability in the clinical field. In the Importance-Performance Analysis, a total of 12 items were included in the quadrant A, including 5 items related to 'cardiovascular emergency care', 4 items to 'respiratory system emergency care', 2 items to 'nervous system emergency care' and 1 item to 'common emergency care'. The results showed a need for intensive improvement in items included in quadrant A which are the high importance low performance items. Conclusion: In order to improve the emergency care of novice nurses, a variety of emergency care education programs on the nervous system and respiratory system care should be implemented as well as cardiovascular emergency care education.

• Korean Circulation Journal
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• 제53권1호
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• pp.17-30
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• 2023

Background and Objectives: To evaluate the impact of smoking in young adults on the risk of cardiovascular disease (CVD) and the clustering effect of behavioral risk factors such as smoking, obesity, and depression. Methods: A Korean nationwide population-based cohort of a total of 3,280,826 participants aged 20-39 years old who underwent 2 consecutive health examinations were included. They were followed up until the date of CVD (myocardial infarction [MI] or stroke), or December 2018 (median, 6 years). Results: Current smoking, early age of smoking initiation, and smoking intensity were associated with an increased risk of CVD incidence. Even after quitting smoking, the risk of MI was still high in quitters compared with non-smokers. Cigarette smoking, obesity, and depression were independently associated with a 1.3-1.7 times increased risk of CVD, and clustering of 2 or more of these behavioral risk factors was associated with a 2-3 times increased risk of CVD in young adults. Conclusions: In young adults, cigarette smoking was associated with the risk of CVD, and the clustering of 2 or more behavioral risk factors showed an additive risk of CVD.

• The Korean Journal of Physiology
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• 제28권2호
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• pp.133-141
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• 1994

The discharge patterns and peripheral nerve inputs to cardiovascular neurons were investigated in rostral ventrolateral medulla (RVLM) and raphe nucleus of cats. The data from the two were compared to determine their roles in cardiovascular regulation and the endogenous analgesic system. Animals were anesthetized with ${\alpha}-chloralose$ and single cell activities were recorded by carbon-filament microelectrode and their relationships with cardiovascular activity were analyzed. In RVLM area, a total of thirty-three cells were identified as cardiovascular neurons. During one cardiac cycle, the mean discharge rate of the neurons was $1.96{\pm}0.29$ and the peak activity was observed 45 ms after the systolic peak of arterial blood pressure. Thirteen cells could be activated antidromically by stimulation of the the $T_2$ intermediolateral nucleus. Forty-three raphe neurons were identified as cardiovascular neurons whose mean discharge rate during one cardiac cycle was $1.02{\pm}0.12$. None of these cells could be activated antidromically. Study of the interval time histogram of RVLM neurons revealed that the time to the first peak was $128{\pm}20.0\;ms$, being shorter than the period of a cardiac cycle. The same parameter found from the raphe neurons was $481{\pm}67.2\;ms$, which was much longer than the cardiac cycle length. Of seventeen RVLM neurons examined ten received only the peripheral $A{\delta}-afferent$ inputs, whereas six RVLM neurons received both $A{\delta}-$ and C-inputs; the remaining one cell received an inhibitory peripheral C-input. In contrast, nine of eleven raphe neurons were found to receive $A{\delta}-inputs$ only. We conclude that the main output of cardiovascular regulatory influences are mediated through the RVLM neurons. The cardiovascular neurons in the raphe nucleus appear to serve as interneurons transferring cardiovascular afferent information to the raphespinal neurons mediating the endogenous analgesic mechanisms.

• 대한한의학회지
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• 제28권3호통권71호
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• pp.289-298
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• 2007

Objectives : Electrical acupoint stimulation (EAS) has been used to treat motor dysfunction of stroke patients with reportedly effective results. The purpose of this study was to evaluate the efficacy of EAS with different frequencies in treating motor dysfunction of ischemic stroke patients. Methods : The subjects of this study were sixty-two ischemic stroke patients with motor dysfunction at Kyunghee Oriental Medicine Hospital who were hospitalized for one week to one month from onset. They were treated with 2Hz or 120Hz EAS for two weeks, and motor evoked potentials (MEP) were measured before and after EAS treatment. To compare the effect of 2Hz EAS with 120Hz, we measured latency, central motor conduction time (CMCT) and amplitude of MEP before and after EAS treatment. Results : After two weeks of treatment, we compared MEP data of the affected side between the 2Hz group and the 120Hz group. The 2Hz group showed more significant improvement than the 120Hz group in latency, CMCT and amplitude (P=0.008, 0.002, 0.002). In case of the affected side MEP data divided by normal side MEP data, the 2Hz group also showed improvement on latency, CMCT and amplitude with significant differences (P=0.003, 0.000, 0.008). Conclusions : These results suggest that low frequency EAS activates the central motor conduction system better than high frequency EAS, and it means that EAS with low frequency is more helpful for motor recovery after ischemic stroke than that with high frequency.

• 한국비블리아학회지
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• 제27권1호
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• pp.111-134
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• 2016

본 연구는 저자동시인용분석 기법을 이용하여 국내와 미국의 심장혈관학(Cardiovascular Research) 분야의 지적구조 규명을 목적으로 하였다. 이를 위해서 2008년부터 2014년까지 국내의 "대한심장학회지"와 미국의 Circulation, Circulation Research를 선정하여 인용빈도 기준으로 각각 45명과 53명의 저자를 추출하였다. 저자동시인용 행렬을 기반으로 다차원척도분석, 군집분석, 요인분석을 실시하였다. 분석결과는 심장혈관학 분야에서 국내와 미국 연구자들은 공통적으로 여러 분야에 걸쳐 다양한 세부 분야에서 연구 활동을 하는 경향을 보였다. 국내와 미국의 심장혈관학 분야는 핵심연구 영역으로 '심혈관질환 치료', '심혈관질환 진단', '심혈관질환 기초과학', '심혈관질환 예방'으로 나타났다. 국내와 미국의 가장 큰 차이로 볼 수 있는 것은 국내 연구는 임상 중심이며, 미국 연구는 기초 의학 중심인 것으로 나타났다. 국내의 경우는 '리듬장애' 분야가 나타났으며, 이에 반해 미국은 '심혈관계 작용약물' 분야를 찾아볼 수 있다. 또한 미국의 분석결과에서는 기초의학 분야의 세부분야인 '역학', '생물학', '생화학', '생리학' 분야가 뚜렷하게 구분되어 나타났다.