• Tuberculosis and Respiratory Diseases
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• v.85 no.4
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• pp.332-340
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• 2022

Background: Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period. Methods: We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation. Results: Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292). Conclusion: Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.

• The Korean Journal of Physiology
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• v.4 no.2
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• pp.5-17
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• 1970

The effects of Physical exercise, gymnastics and sports on the cardiopulmonary function were studied in the middle and high school toys. The subjects were divided into 4 groups; non-training group and training group in both middle school and high school boys. In the above groups, pulmonary function studies were performed, and blood pressure and the heart rate were also checked to evaluate physical fitness during and immediately after running exercise on the tread-mill, with the speed of 5 MPH and elevation of 9% and 11.25%. The types of sports in the training group were base ball, body building, Taekwondo (Korean style boxing) and hand ball. The results obtained were as followings: 1) In the training group, cardiopulmonary function showed some tendency of the increase comparing to the non-training group. 2) The increase in cardiopulmonary function was observed according to the age became older, but the clear changes on cardiopulmonary function was not observed as the difference of the group between the training and the non-training. 3) The expiratory volume was decreased as the increase of age except 17 years of age for the value of the per kg body weight. 4) In the non-training group, the mean value of oxygen consumption under maximum work load was increased, while those in the training group was decreased. But it may be noted that oxygen consumption for the expiratory volume was increased in the training group, and that the oxygen cost in the training group was .higher than that of the non-training group. 5) The pulse pressure of the high school group during and immediately after running exercise was observed in the higher value comparing with that of the middle school group It was suggested that the changes of the pulse pressure was owing to the method of determination and that to the decrease of diastolic pressure caused by the decrease of peripheral vascular resistance up to critical closing pressure. 6) Any differences of the changes in the heart rate between the training group and non-training group was not observed during and immediately after running exercise. 7) The relative value of the expiratory volume to the heart rate was decreased in the elder age group.

• Investigative Magnetic Resonance Imaging
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• v.12 no.1
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• pp.40-48
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• 2008

Purpose : We sought to determine the early change of ventricular geometry and function after concomitant surgeries of modified Dor procedure and mitral valve annuloplasty by using magnetic resonance imaging. Materials and Methods : We enrolled 21 patients with dilated heart failure who underwent modified Dor procedure (n=8), mitral valve annuloplasty (n=6), or both surgeries (n=7). Cine MRI was used to assess left ventricular dimensions and function before and after surgery. We measured the left ventricular end-diastolic and end-systolic volumes and the dimensions of the left ventricular long-axis and short-axis. Left ventricular stroke volume, ejection fraction, and sphericity index were calculated from these measurements. These parameters were analyzed and compared between three different surgery groups to explain the combined effect of the concomitant surgeries. Results : MRI was performed within average $12\;{\pm}\;15$ days (range 1-58 days) before and $38\;{\pm}\;50$ days (range 7- 231 days) after the surgery. The patients who underwent concomitant surgeries had more profound enlargement of left ventricle and decreased contractility prior to surgery than those in the patients who underwent single surgical procedure. Left ventricular end-diastolic volume and endsystolic volume significantly decreased in all patients regardless of surgery type after surgery. Ejection fraction significantly increased only in the patients who got modified Dor procedure without mitral valve annuloplasty (25.4% to 40.7%). Sphericity index increased in patients with modified Dor procedure but decreased in patients with mitral valve annuloplasty (0.65 to 0.78 vs. 0.75 to 0.65). In the patients who underwent concomitant surgeries showed no significant change in sphericity index after surgery. Conclusion : The early change of the left ventricular geometry and function after the concomitant surgeries with modified Dor procedure and mitral valve annuloplasty in patients with dilated heart failure includes a marked reduction in left ventricular volume and in stroke volume. The shape of the left ventricle does not change because the effect of sphericity index decrease from mitral valve annuloplasty is counteracted by the effect of sphericity index increase from modified Dor procedure. Improvement of left ventricular ejection fraction is not the early change after the concomitant surgeries.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.1
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• pp.237-244
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• 2009

We investigated the effects of acupuncture stimulation on pulse wave variables and heart rate variability (HRV) in healthy adults. To evaluate twenty healthy volunteers (10 men, 10 women) had acupuncture into both Hapkok (Ll4) and Taechung (Liv3) for 15 minutes. Radial pulse, Heart Rate Variability, body temperature and blood pressure were checked before and after acupuncture to evaluate Pulse Wave Variability and Autonomous Function. The results were as follows; Heart rate was significantly increased while systolic blood pressure (mmHg) and diastolic blood pressure (mmHg) were significantly increased after acupuncture treatment. Sixteen subjects didn't change representative pulse wave variables after acupuncture treatment. Energy, height of main peak (H1), height of pre-dicrotic valley (H2) and height of descending valley (H4) were decreased while height of dicrotic peak (H5) was significantly decreased after acupuncture treatment. Time to main peak (T1), time to pre-dicrotic valley (T2), time to dicrotic peak (T5), total time (T) and T-T4 were decreased while time to descending valley (T4) was increased after acupuncture treatment. Total area (At), area of main peak (Aw) and ratio of diastolic period area (Ad) were decreased while ratio of systolic period area (As) and angle of main peak (MPA) were increased after acupuncture treatment. The standard deviation of all normal RR intervals (SDNN) was increased while the root mean square of successive differences between the normal heart beats (RMSSD) was significantly increased after acupuncture treatment by time domain analysis. Low frequency power (LF) and LF/HF ratio were decreased while high frequency power (HF) was significantly increased after acupuncture treatment by frequency domain analysis. This study suggests that acupuncture treatment changes pulse wave variability and heart rate variability. Further study on various acupuncture treatment for pulse wave variability and heart rate variability is required.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.289-294
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• 2011

The aim of this study is to evaluate the differences of ejection fraction of left ventricle through the quantitative analysis of diastolic and systolic volumes according to slices selected using cardiac MR imaging. A total of 12 volunteers (7 normal, 1 myocardium bridge, and 4 arrhythmia) underwent cardiac MRI on a MR scanner(Magnetom Trio, Siemens, Germany). Ejection fractions for quantitative analysis were calculated at single slice of center of left ventricle, 3, 5, and 6-7 slices extending from the center of left ventricle. Average values were analyzed for evaluating differences of ejection fraction according to the number of slices selected. Mean value of normal person of ejection fraction were 67.14% at single slice of center of left ventricle, 66.24% at 3 slices, 65.63% at 5 slices, and 65.29% at 6-7 slices. While ejection fraction obtained from a patient with 61.74% at single slice of center of left ventricle, 60.92% at 3 slices, 60.89% at 5 slices, and 61.89% at 6-7 slices. There was no significant differences by the number of slices selected. This study demonstrates that ejection fraction obtained from single slice of center of left ventricle may represent a optimum parameter for cardiac function, instead of the value calculated on the variable slices selected.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.970-975
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• 2012

In Sasang constitutional medicine, doctors diagnose and treat patients according to their Sasang consitutition (SC) type. In this work, by a clinical test with a radial pulse tonometer, we investigated radial pulse properties which were significant in distinguishing unhealthy subjects from healthy subjects for each SC type. We measured radial pulse properties on left and right Gwan locations with a pulse tonometer for 299 elderly female subjects of age of 50 years old or above. We used a newly developed SCAT system to determine subjects' SC types. Subjects' health levels of either healthy or unhealthy were determined independently by two Korean medical doctors. To investigate the statistical differences, we used either of Student's t-test or Mann-Whitney U test depending on the normality of distribution of test statistic. For TE type, unhealthy subjects were characterized with significant increases in heart rate, systolic to diastolic period, pulse depth, while they showed significant decreases in width of pulse in normal direction, pulse area in diastolic period, and high harmonic components (6th, 7th) of power spectral density. For SE type, unhealthy subjects were characterized with significant increases in pulse pressure and pulse depth, while no significant differences were found for SY type. We investigated the characteristic differences in radial pulse properties due to change in health levels on each SC type for elderly females. Pulse variables which were significantly different between healthy subjects and unhealthy subjects were found to vary between SC types. For TE type subjects, many variables were found significant at the left Gwan location, which is in support of the theory of hyperactive liver functioning for TE type. Irrespective of the constitution, the related changes in the pulse properties due to worsened health level were in support of elevated blood flow amount in compensation with weakened blood circulatory function.

• Korean Journal of Radiology
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• v.22 no.9
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• pp.1525-1536
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• 2021

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7-18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959-0.991; p < 0.001) as well as right (0.755-0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion: The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.168-179
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• 2007

Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.833-852
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• 1996

Regular long term dance movement could be one of ways to induce improvement of psychophysiological variables, resulting in improvement of quality of life. However, there have been few studies to evaluate the effect of dance movement training on both physiological and psychological variables in the elderly. This study was focused to determine the effect of Korean traditional dance movement training on psychophysiological variables-body weight, body fat, lean body mass, muscle strength, muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction-in Korean elderly women. Thirty four subjects, aged between 65 and 75years who have normal cognition, sensory function, cerebellum function, cardiovascular function, participated in this study. Seventeen experimental group subjects were selected from E-elderly university in Kyung Gi province, and Seventeen control group subjects were selected from N-welfare facility in Seoul City. Seventeen experimental group subjects participated for 12weeks dance movement program. Korean traditional dance movement program was developed on the basis of Korean traditional dance and music by the author. The program consisted of approximately 50minutes of dance, 3times a week for 12weeks. During 50minutes workout, there were 15minutes of warm-up dancing, 25minutes of conditioning dance and 10minutes of cool-down dancing. The intensity for the conditioning phase was at between 60% and 65% of age-adjusted maximum heart rates. The body weight, body fat, lean body mass, muscle strength(grip strength, leg strength), muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satis-faction were measured prior to and following the experimental treatment. The participants in dance movement were interviewed focusing on subjective feeling following 12 week's regular dance movement. Data were analyzed with mean, standard deviation, percentage of change, X²-test, t-test, and ANCOVA test using SPSS PC/sup +/ program. Subjective feeling was categorized into cognitopsy-chological and physiological responses. Results were obtained as follows : 1) The body weight (F=15.52, p=.000), body fat (F=18.33, p=.000) and lean body mass (F=7.28, p=.011) of the experimental group were significantly lower than those of the control group following the dance movement training. 2) The leg strength (F=30.96, p=.000), muscle endurance (F=9.06, p=.005), agility(F=44.92, 000), flexibility(F=6.84, p=.014) of the experimental group were significantly higher than those of the control group following the dance movement training. There was no significant difference of grip strength(F=.43, p=.515) between experimental and control groups. 3) The heart rate(F=26.96, p=.000), systolic (F=10.40, p=.000) and diastolic(F=3.99, p=.005) blood pressure at rest of the experimental group were significantly lower than those of the control group following the dance movement training. 4) No significant difference of score of depression (F=3.49, p=.071) was observed between experimental and control groups. 5) Score of life satisfaction of experimental group was remarkably higher than that of control group following 12weeks of dance movement training (p<0.05). 6) Thematic responses about the dance movement following the training were positive. "I feel good" was the most frequent among cognitopsychological responses and "I feel lightness of body" was the most frequent among physiological responses. The results suggest that Korean traditional dance movement training can improve psychophysiological variables of Korean elderly.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.211-222
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• 1988

Tetralogy of Fallot is a cyanotic congenital heart disease characterized by large ventricular septal defect[VSD] and stenosis of right ventricular outflow tract[RVOT] and the degree of RVOT stenosis and the state of pulmonary arteries are the major determinant of prognosis of this anomaly after operation. The sum of blood flow through RVOT and collateral flow from systemic arteries determine the total pulmonary blood flow and it is drained to left atrium and left ventricle. Therefore the degree of development of left ventricle not only reflects pulmonary blood flow and the status of peripheral pulmonary arteries but also affects postoperative prognosis as a systemic ventricle. In this article, left ventricular volume and its influence on postoperative cardiac function in tetralogy of Fallot were studied in 34 patients operated on at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital in 1985. Mean age of the patients was 5 1/12*3 9/12 years[range 9/12 - 14 8/12 years], mean body surface area[BSA] 0.65*0.20m2[range 0.38 - 1.22m2], mean body weight 15.6k6.48kg[range 7.0 - 36kg]and mean hematocrit 50.6*9.77%[range 32.0 - 73.5%]. Left ventricular end-diastolic volume[LVEDV] of them were from 11.2 to 113cc and there was a good linear correlation between BSA[m2, X]and LVEDV[cc, Y][Y= - 20.0+923x, r= 0.84, p < 0.005]. Mean LVEDV/m2 was [57.6 * 18.3 cc / m2[range 28.7 - 95.8 cc / m2] and there was a significant reduction of volume compared with normal value. As body surface increases, there was a increasing tendency in LVEDV/m2 but there was no statistical significance. Mean total amount of postoperatively infused dopamine in these 33 patients[except one who expired postoperatively] was 65.6*74.5mg / kg and it was 40.6*44.0mg / kg in routine RVOT widening group [Group I] and 205*49.3mg / kg in transannular RVOT widening group[Group II]. There was a statistically significant difference between two groups. In group I patients there was a good linear inverse correlation between dopamine total amount[mg / kg, Y] and LV volume[cc / m2, X] [Y = 150 - 1.89 X, r = - 0. 77, p < 0.005]. But there were no correlations between dopamine total amount and Hct, cardiopulmonary bypass time and aorta cross clamp time. In conclusion, the patient with small preoperative left ventricular volume required more amount of dopamine as an inotropic agent for the maintenance of a cardiac function in postoperative period. But this is a result of immediate postoperative period and does not reflect the long term effect of left ventricular volume in tetralogy of Fallot. There must be more study for the evaluation of its long term effect.