• Korean Journal of Exercise Nutrition
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• v.25 no.2
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• pp.8-14
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• 2021

[Purpose] The purpose of this study was to investigate the effects of a high-fat high-sucrose (HFHS) diet on previously reported adaptations of cardiac morphological and contractile properties to resistance training. [Methods] Twelve-week-old rats participated in 12-weeks of resistance exercise training and consumed an HFHS diet. Echocardiography and skinned cardiac muscle fiber bundle testing were performed to determine the structural and mechanical adaptations. [Results] Compared to chow-fed sedentary animals, both HFHS- and chow-fed resistance-trained animals had thicker left ventricular walls. Isolated trabecular fiber bundles from chow-fed resistance-trained animals had greater force output, shortening velocities, and calcium sensitivities than those of chow-fed sedentary controls. However, trabeculae from the HFHS resistance-trained animals had greater force output but no change in unloaded shortening velocity or calcium sensitivity than those of the chow-fed sedentary group animals. [Conclusion] Resistance exercise training led to positive structural and mechanical adaptations of the heart, which were partly offset by the HFHS diet.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.706-709
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• 1987

From December 1981 to June 1987, thirty one patients suffering from low output syndrome after cardiac operation received cardiac assist with intraaortic balloon pump. Fifteen patients survived [survival rate 48.4%]. After receiving assist with IABP, urine output increased, heart rate and central venous pressure decreased, reflecting improved myocardial performance. Poor preoperative hemodynamic and functional status resulted in poor survival despite of assist with IABP. Poor pre-IABP hemodynamic status also resulted in high mortality after assist with IABP. Our experience suggests that IABP should be introduced early in the course of worsening to get good result.

• Biomedical Science Letters
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• v.12 no.3
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• pp.289-301
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• 2006

Cardiopulmonary bypass (CPB) for cardiac surgery triggers the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that leads to postoperative major organ dysfunction. Traditionally, corticosteroids (steroid) have been administered to patients undergoing cardiac surgery to ward off these detrimental physiologic alterations. However, the majority of the studies have been performed on adult patients with high-dose steroid. We carried out a randomized, prospective, double-blind study to compare the efficacy of low-dose steroid with that of high-dose steroid and to determine the adequate dose of pretreated-steroid for prophylactic effects in pediatric cardiac surgery. Thirty pediatric patients scheduled for elective cardiac surgery were randomly assigned to two groups; fifteen patients received low-dose methylprednisolone (10mg/kg intravenously, n=15, low-dose group) and the others received high-dose methylprednisolone (30mg/kg intravenously, n=15, high-dose group) 1 hour prior to CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after start of CPB (CPB-10), and immediately after CPB-end (CPB-OFF) for measuring total leukocyte counts (T-WBC) and diff-counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), total antioxidant (TAO), neuron-specific enolase (NSE), troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and blood urea nitrogen (BUN) levels. Other parameters such as volumes of urine output, pulmonary index $(PI,\;PaO_2/FiO_2)$, mechanical ventilating period, intensive care unit (ICU)-staying period, postoperative complications (fever, wound problem), postoperative 24 hrs and total volumes in blood loss, and hospitalized days were also assessed. All parameters were compared between two groups. There were no significant differences in T-WBC counts, monocyte fraction, platelet counts, TA levels, NSE levels, creatinine levels, BUN levels, the volumes of total urine output, PI, the incidences of fever and wound problem, postoperative 24hrs- and total-blood loss volumes and ICU-staying period between two groups (P>0.05). At CPB-OFF, neutrophil fraction, MPO level, TNI level, and AST level were higher in the high-dose group than in the low-dose group (P<0.05). IL-6 level at CPB-10 was higher in the high dose-group than in the low-dose group (P<0.05). Furthermore, mechanical ventilating periods and hospitalized days of the high-dose group were significantly longer than those of low-dose group (P<0.05). The high-dose group had significantly low lymphocyte fi-action at CPB-OFF compared with the low-dose group (P<0.001). These findings suggest that pretreatment of high-dose steroid is not superior to that of low-dose steroid regrading its potential benefits in pediatric cardiac surgery. Therefore, the conventional strategy of steroid treatment, high-dose pretreatment, should be modified in the cardiac surgery with CPB. However, further studies must be performed on the larger number of patients in as much as small number of patients in this study.

• Journal of Chest Surgery
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• v.51 no.2
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• pp.109-113
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• 2018

Background: Low cardiac output syndrome (LCOS) after cardiac surgery usually requires inotropes. In this setting, critical illness-related corticosteroid insufficiency (CIRCI) may develop. We aimed to investigate the clinical features of CIRCI in the presence of LCOS and to assess the efficacy of steroid treatment. Methods: We reviewed 28 patients who underwent a rapid adrenocorticotropic hormone (ACTH) test due to the suspicion of CIRCI between February 2010 and September 2014. CIRCI was diagnosed by a change in serum cortisol of <$9{\mu}g/dL$ after the ACTH test or a random cortisol level of <$10{\mu}g/dL$. Results: Twenty of the 28 patients met the diagnostic criteria. The patients with CIRCI showed higher Sequential Organ Failure Assessment (SOFA) scores than those without CIRCI ($16.1{\pm}2.3$ vs. $11.4{\pm}3.5$, p=0.001). Six of the patients with CIRCI (30%) received glucocorticoids. With an average elevation of the mean blood pressure by $22.2{\pm}8.7mm\;Hg$ after steroid therapy, the duration of inotropic support was shorter in the steroid group than in the non-steroid group ($14.1{\pm}2.3days$ versus $30{\pm}22.8days$, p=0.001). Three infections (15%) developed in the non-steroid group, but this was not a significant between-group difference. Conclusion: CIRCI should be suspected in patients with LCOS after cardiac surgery, especially in patients with a high SOFA score. Glucocorticoid replacement therapy may be considered to reduce the use of inotropes without posing an additional risk of infection.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.618-626
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• 1986

Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.580-588
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• 1989

The potential for enhancing myocardial protection by adding high-energy phosphate to cardioplegic solutions [St. Thomas Hospital solution] was investigated in a rat heart model of cardiopulmonary bypass and ischemic arrest. Creatine phosphate was evaluated as an additive to the St. Thomas Hospital cardioplegic solution. Creatine phosphate 10.0 mmol/L as the optimal concentration which improved recovery of aortic flow and cardiac output after a 30 minute period of normothermic [37oC] ischemic arrest. In comparing mechanical function in both groups the mean postischemic recoveries of aortic flow, cardiac output, stroke volume and stroke work [expressed as a percentage of its preischemic control] were significantly greater in STH-CP group than in CP- free control group. In addition to improving function and decreasing CK release, CP reduced reperfusion arrhythmias significantly decreasing the time between cross-clamp removal and return to regular rhythm from 81.8 * 13.9 [sec] in CP-free group to 35.9 * 6.8 [sec] in CP group [P< 0.05] so, exogenous CP exerts potent protective and antiarrhythmic effects when added to the St. Thomas Hospital cardioplegic solution. However, the mechanism of action remains to be elucidated.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.47 no.6
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• pp.869-873
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• 2014

Cardiorespiratory variables were measured in flounder Paralicthys olivaceus exposed to acidified seawater equilibrated with a gas mixture containing 5% $CO_2$ gas for 72 h at $20^{\circ}C$. It was found that $CO_2$ produced a significant increase in arterial $PCO_2$ ($PaCO_2$) and significant decreases in arterial pH (pHa). $CO_2$ transiently increased heart rate within 30 min of exposure. After cardiac output was elevated by the increase in heart rate within 30 min, was then reduced by the decrease in both stroke volume and heart rate. The heart responses of flounder differ from those of yellowtail to high $CO_2$ environment.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.64 no.8
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• pp.1251-1255
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• 2015

The purpose of this study is to measurement the cardiac output using hand to hand impedance method to provide convenience to user when measuring SV(stroke volume) with the use of ICG(Impedance Cardiography). We suggest the optimized modified formula, which can be applied when using impedance with the use of hand to hand Impedance. To verify this formula, a SV from transthoracic approach and hand to hand approach are compared for the 36 subjects, respectively. The acquired data was analyzed by using LabVIEW 8.6, analysis was implemented by SPSS 12.0. Fine difference was shown by individual. We showed that as a result of analyzing the ICG measurement value on thoracic and hand to hand, the correlation with SV was r=0.716, thereby having indicated the results of regression model in relatively high correlation.

• Journal of Chest Surgery
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• v.45 no.3
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• pp.161-165
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• 2012

Background: Median sternotomy can weaken the upper abdominal wall and result in subxiphoid incisional hernia. We evaluated risk factors associated with the development of subxiphoid incisional hernias after coronary artery bypass grafting (CABG). Materials and Methods: Of 1,656 isolated CABGs performed between January 2001 and July 2010, 1,599 patients who were completely followed up were analyzed. The mean follow-up duration was $49.5{\pm}34.3$ months. Subxiphoid incisional hernia requiring surgical repair developed in 13 patients (0.8%). The hernia was diagnosed $16.3{\pm}10.3$ months postoperatively, and hernia repair was performed $25.0{\pm}26.1$ months after the initial operation. Risk factors associated with the development of subxiphoid incisional hernia were analyzed with the Cox proportional hazard model. Results: Five-year freedom from the hernia was 99.0%. Univariate analysis revealed that female sex (p=0.019), height (p=0.019), body surface area (p=0.046), redo operation (p=0.012), off-pump CABG (p=0.049), a postoperative wound problem (p=0.041), postoperative bleeding (p=0.046), and low cardiac output syndrome (p<0.001) were risk factors for the development of the hernia. Multivariable analysis showed that female sex (p=0.01) and low cardiac output syndrome (p<0.001) were associated with subxiphoid hernia formation. Conclusion: Female sex and postoperative low cardiac output syndrome were risk factors of subxiphoid hernia. Therefore, special attention is needed for patients with high-risk factors.

• The Korean Journal of Nuclear Medicine
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• v.8 no.1_2
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• pp.1-11
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• 1974

The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto es during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1. Plasma volume was increased in the patients during the oliguric-and hypertensive diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2. Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3. Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4. Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5. Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance in these cases. Relatively increased circulating blood volume due to decreased effective vascular space was suggested for the mechanism of relative hypervolemia. 6. Cardiac hemodynamic alteration returned to normal during late stage of the diuretic phase, while renal hemodynamic changes were normalized at six months after the onset.