• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.274-279
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• 2002

The sick sinus syndrome refers to a combination of symptoms (dizziness, confusion, fatigue, syncope, and congestive heart failure) caused by sinus node dysfunction and marked sinus bradycardia, sinoarterial block, or sinus arrest. 'Abdominal pulsation' means a disagreeable symptom that is defined as sensation of beating at the abdomen. We experienced a 84 year-old female patient who had dizziness, fatigue, abdominal pulsation and frequent voiding. These symptoms were related to previous episodes and presumed sick sinus syndrome by symptoms, ECGs and 24 hrs of holter monitoring. In the point of Differentiation of Syndrome (辨證), this patient was diagnosed as 'Water retention(水氣)' and was administered with Yeonggyechulgam-tang(岺桂朮甘湯). After the treatment, abdominal pulsation (frequency) and dizziness (VAS) were improved. Futhermore, the interval of voiding was longer and each volume of urination increased.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.61-66
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• 1982

The present study was performed to evaluate hemodynamic effects on the pericardial patch graft for stenosis of right ventricle outflow tract in 19 patients of tetralogy of Fallot. The stenosis of right ventricle outflow tract was associated with or without pulmonary annular nar-rowing, pulmonary valvular stenosis, and hypoplastic narrowing of pulmonary artery. Total correction of tetralogy of Fallot was performed under cardiopulmonary bypass with moderate hypothermia and cardioplegic cardiac arrest. Ventricular septal defects were closed with Teflon patch graft. The chamber pressures in the heart were measured before and after a total correction of tetralogy of Fallot. The data of pressure measurement and the results of postoperative observation of pericardial patch were as followings: 1. Systolic and diastolic pressure of right ventricle was decreased after operation from $96.0{\pm}14.7/10.0{\pm}14.4mmHg$ to $61.0{\pm}13.1/8.0{\pm}9.3mmHg$. 2. Systolic and diastolic pressure of pulmonary artery was increased after operation from $18.0{\pm}5.6/10.0{\pm}5.5mmHg$ to $31.0{\pm}10.7/14.0{\pm}4.9mmHg$. 3. Preoperative pressure gradient between right ventricle and pulmonary artery was decreased immediately after operation from 78.0mmHg to 30.0mmHg. 4. It was observed that excellent widening effects of right ventricle outflow tract was resulted from pericardial patch graft. 5. No postoperative bleeding from pericardial patch graft was observed. 6. Aneurysm formation of pericardial patch was not be observed during 1 to 6 years postoperative periods.

• Journal of Chest Surgery
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• v.46 no.1
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• pp.41-48
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• 2013

Background: We present our 12-year experience of pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Materials and Methods: Between January 1999 and March 2011, 16 patients underwent pulmonary thromboendarterectomy. Eleven patients (69%) were classified as functional class III or IV based on the New York Heart Association (NYHA) classification. Seven patients had a history of inferior vena cava filter insertion, and 5 patients showed coagulation disorders. Pulmonary thromboendarterectomy was performed during total circulatory arrest with deep hypothermia in 14 patients. Results: In-hospital mortality and late death occurred in 2 patients (12.5%) and 1 patient (6.3%), respectively. Extracorporeal membrane oxygenation support was required in 4 patients who developed severe hypoxemia after surgery. Thirteen of the 14 survivors have been followed up for 54 months (range, 2 to 141 months). The pulmonary arterial systolic pressure and cardiothoracic ratio on chest radiography was significantly decreased after surgery ($76{\pm}26$ mmHg vs. $41{\pm}17$ mmHg, p=0.001; $55%{\pm}8%$ vs. $48%{\pm}3%$, p=0.003). Tricuspid regurgitation was reduced from $2.1{\pm}1.1$ to $0.7{\pm}0.6$ (p=0.007), and the NYHA functional class was also improved to I or II in 13 patients (81%). These symptomatic and hemodynamic improvements maintained during the late follow-up period. Conclusion: Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension shows good clinical outcomes with acceptable early and long term mortality.

• Journal of Biomedical Engineering Research
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• v.38 no.3
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• pp.123-128
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• 2017

Background and aims: The KCNQ1 S140G mutation involved in $I_{ks}$ channel is a typical gene mutation affecting atrial fibrillation. However, despite the possibility that the S140G gene mutation may affect not only atrial but also ventricular action potential shape and ventricular responses, there is a lack of research on the relationship between this mutation and ventricular fibrillation. Therefore, in this study, we analyzed the correlation and the influence of the KCNQ1 S140G mutant gene on ventricular fibrillation through computer simulation studies. Method: This study simulated a 3-dimensional ventricular model of the wild type(WT) and the S140G mutant conditions. It was performed by dividing into normal sinus rhythm simulation and reentrant wave propagation simulation. For the sinus rhythm, a ventricular model with Purkinje fiber was used. For the reentrant propagation simulation, a ventricular model was used to confirm the occurrence of spiral wave using S1-S2 protocol. Results: The result showed that 41% shortening of action potential duration(APD) was observed due to augmented $I_{ks}$ current in S140G mutation group. The shortened APD contributed to reduce wavelength 39% in sinus rhythm simulation. The shortened wavelength in cardiac tissue allowed re-entrant circuits to form and increased the probability of sustaining ventricular fibrillation, while ventricular electrical propagation with normal wavelength(20.8 cm in wild type) are unlikely to initiate re-entry. Conclusion: In conclusion, KCNQ1 S140G mutation can reduce the threshold of the re-entrant wave substrate in ventricular cells, increasing the spatial vulnerability of tissue and the sensitivity of the fibrillation. That is, S140G mutation can induce ventricular fibrillation easily. It means that S140G mutant can increase the risk of arrhythmias such as cardiac arrest due to heart failure.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.216-231
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• 2003

Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

• Journal of forensic and investigative science
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• v.1 no.1
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• pp.72-87
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• 2006

Accidents and terrorist acts that utilize explosives have a great influence on society and thus require a prompt investigation for the arrest of the culprit. However, such investigations are often met with difficulties due to the vastness of the crime scene, restrictions on approaching the scene, fragility of the evidence, complexity of investigation, and the lack of expertise. In spite of such facts, scientific investigation regarding explosives have not been widely studied in Korea. Therefore, the focus of this research primarily concerns the effective scientific investigation methods in cases of accidents that involve chemical explosives. Although the a systematic investigation method is at the heart of scientific investigation in cases of explosive accidents, it is only at its rudimentary stage. Therefore, in this research, a systematic investigation method is put forth for the 'scene investigation, the documentation of the scene, and the collection and processing of evidence. Further, I have set forth a 'scene investigation check list' the ensure a thorough scene investigation and to promote an exhaustive evidence collection that would guarantee the admissibility of such evidence in court. The above efforts were aimed at simplifying the currently complicated investigation system. 1) In the future, a guidebook that can be generally applied to accidents involving explosives in Korea ught to be produced, a continual systematic education and integrated training excises for investigators ought to be established, laws that require additives in explosives ought to be instituted so that the type, components, and source of explosives can be identified, and lastly, a database that contain information on former explosion accidents, trends, and techniques of criminal activities that involve explosion accidents should be compiled.

• Korean Journal of Pharmacognosy
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• v.33 no.2 s.129
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• pp.130-136
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• 2002

Melanogenesis is a physiological process resulting in the synthesis of melanin pigments, which play a crucial protective role against skin photocarcinogenesis. The heart wood of Caesalpinia sappan L.(C. sappan) has long been commonly used in Oriental folk medicines to promote blood circulation, and as an emmenagogue, analgesic or anti-inflammatory agent as well as a remedy for thrombosis. From the heartwood, many constituents have been purified and among them, brazilin and hematoxylin are two of the most abundant. This present study was designed to investigate the inhibitory effect of butanol extract from C. sappan on proliferation and melanogenesis in Melan-a cells. After 48 h treatment of these cells with various concentrations of butanol extract, the cells showed a dose-dependent inhibition in their proliferation without apoptotic cell death. Therefore, the growth retardation by the extract may be due to the cell arrest or cell differentiation. We also estimated total melanin content as a final product and activity of tyrosinase, a key enzyme, of melanogenesis in Melan-a cells. The melanin content and tyrosinase activity were deσeased in extract-treated cells in a dose dependent manner compared to control group. The butanol extract also resulted in a decrease of melanin content in ${\alpha}-melanocyte-stimulating$ hormone (MSH)-induced melanogenesis, indicating that butanol extract of C. sappan could be developed as skin whitening components of cosmetics.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.304-307
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• 2010

A 5-day-old neonate (body weight=2.4 kg) with coarctation of the aorta and critical aortic stenosis underwent an interventional balloon valvuloplasty for aortic stenosis. During the intervention, cardiac arrest occurred due to injury of the right carotid artery by the guide wire. An extracorporeal membrane oxygenator (ECMO) was applied. After 1 day's support, total surgical correction was achieved; however, in the immediate postoperative period, cardiac function was severely depressed. We applied a bi-ventricular assist device (bi-VAD) instead of an ECMO and we were able to wean the patient off the bi-VAD device after 3 days' support. The patient was discharged without severe complications.

• Biomolecules & Therapeutics
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• v.26 no.2
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• pp.175-181
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• 2018

Carbon monoxide (CO) is well-known as toxic gas and intrinsic signaling molecule such as neurotransmitter and blood vessel relaxant. Recently, it has been reported that low concentration of CO exerts therapeutic actions under various pathological conditions including liver failure, heart failure, gastric cancer, and cardiac arrest. However, little has been known about the effect of CO in neurodegenerative diseases like Parkinson's disease (PD). To test whether CO could exert a beneficial action during oxidative cell death in PD, we examined the effects of CO on 6-hydroxydopamine (6-OHDA)-induced cell death in C6 glioma cells. Treatment of CO-releasing molecule-2 (CORM-2) significantly attenuated 6-OHDA-induced apoptotic cell death in a dose-dependent manner. CORM-2 treatment decreased Bax/Bcl2 ratio and caspase-3 activity, which had been increased by 6-OHDA. CORM-2 increased phosphorylation of NF-E2-related factor 2 (Nrf2) which is a transcription factor regulating antioxidant proteins. Subsequently, CORM-2 also increased the expression of heme oxygenase-1 and superoxide dismutases (CuZnSOD and MnSOD), which were antioxidant enzymes regulated by Nrf2. These results suggest that CO released by CORM-2 treatment may have protective effects against oxidative cell death in PD through the potentiation of cellular adaptive survival responses via activation of Nrf2 and upregulation of heme oxygenase-1, leading to increasing antioxidant defense capacity.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.190-198
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• 1983

The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.